The efficacy and tolerability of interferon-agr; and -bgr; (IFNagr;, IFNbgr;) in the treatment of hepatitis C virus (HCV)-related chronic hepatitis were compared. 20 consecutive patients with elevated alanine aminotransferase (ALT) levels for at least 6 months, anti-HCV positivity, and a recent hepatic biopsy indicating chronic hepatitis were recruited. 10 patients were randomised to receive natural fibroblast IFNbgr; and 10 to receive lymphoblastoid IFNagr;, both at a dose of 3 million units 3 times weekly for 6 months given as subcutaneous injections. Responses were classified as complete when ALT normalised and partial when ALT was reduced by at least 50percnt; at the end of IFN treatment; a sustained response was defined as no new increase in ALT in the responders in the 6 months after treatment suspension. There were 4 complete and 3 partial responses in the IFNbgr; group compared with 5 and 1, respectively, in the IFNagr; group. Three of the complete responses in the former group and 4 in the latter group were sustained, but none of the partial responses were. After discontinuation of IFN, HCV-RNA polymerase chain reaction (PCR) test remained negative only in patients with a sustained response. None of the differences were statistically significant. Adverse effects were observed in 8 of the subjects given IFNbgr; and in 7 who received IFNagr;. All IFNagr;-treated patients but only 4 IFNbgr;-treated patients had 3 or more associated adverse effects. Furthermore, in the IFNbgr; group fever occurred only in the first week of treatment and leucopenia was much less frequent (2 of 10vs6 of 10 in the IFNagr; arm). These results suggest that the efficacy of natural IFNbgr; administered subcutaneously approaches that of IFNagr; in the treatment of chronic hepatitis C, and that the impact of treatment in terms of adverse effects is possibly less.
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