Successful Long-term Application of Highly Purified Natural Interferon-alpha (Multiferon®) after Preceding Interferon Approaches in a Chronic Hepatitis C Patient with Thrombocytopenia

Re-treatment with highly purified nIFNα in Mexican nonresponder patients with chronic genotype 1 hepatitis C

BACKGROUND AND AIMS

We undertook this study to evaluate the virological response to and presence of adverse events to natural interferon α (nIFNα; Multiferon®) treatment in previously nonresponsive Mexican patients chronically infected with genotype 1 hepatitis C.

METHODS

Thirty-nine patients received a 4-week induction of 5 days/week of 6 MU nIFNα plus weight-based ribavirin followed by 3 MU of nIFNα three times a week for 44 weeks. The relationship between viral response and incidence of adverse events was analyzed.

RESULTS

Early viral response (EVR) was age- and sex-dependent, with older male patients being less responsive. Sustained viral response (SVR) was evaluated according to: a) intention to treat analysis, b) 48-week treatment and 24-week follow-up (16 patients), and c) patients with EVR (11 patients). None of the factors was significantly different in groups a) and b); however, in group c) there was a better response with a marked viral load decline in younger patients and in patients aged 50 years and older. Five of 39 (13%) patients who completed treatment presented with an SVR. The most common adverse effect was asthenia in 27% of patients.

CONCLUSIONS

nIFNα could be a useful strategy for re-treatment in chronic hepatitis C, genotype 1, in previously nonresponsive patients. Confirmation of these data in a larger population is required.

Comparison of antiviral activity of recombinant and natural interferons against crimean-congo hemorrhagic Fever virus

As a first line of defence against a virus infection, mammalian cells elicit an innate immune response, characterized by secretion of type I interferons (IFN) and up-regulation of interferon stimulated genes (ISGs). We have previously included Crimean Congo Hemorrhagic Fever Virus (CCHFV) in the list of type I IFN-sensitive viruses. In this in vitro study, we have compared the antiviral activity of two recombinant IFN-alpha preparations (Roferon A and Intron A) with a natural IFN-alpha produced in human leukocytes (Multiferon). Our results clearly demonstrate that these commercially available IFNs have significant antiviral activities against CCHFV. However, we could show that Multiferon inhibits viral replication more efficiently than the two recombinant IFN alpha preparations.

Interferon alpha delivery systems for the treatment of hepatitis C

Hepatitis C virus (HCV) infections are the most common chronic blood-borne viral infections in the world. The prevalence of HCV infections varies significantly by race or ethnicity, with a high prevalence of the disease displayed in the Hispanic population. Additionally, Hispanics with chronic HCV have also more advanced hepatic fibrosis and faster liver fibrosis progression rates than either African Americans or Caucasians. Furthermore, a higher prevalence of cirrhosis and extent of mortality from liver cirrhosis is also observed in the Hispanic population compared with other groups. Current recommendations for treatment of hepatitis C are interferon alpha (IFNalpha)-based monotherapy and combination of IFNalpha preparations with ribavirin. Future treatment regimens will still be based on IFNalpha therapy with or without other effective antiviral agents, currently under investigation. However, there are some inherent limitations, mainly their relative short systemic circulation lifespan, and their unwanted effects on some non-target tissues. New research focuses on the development of novel modified interferon molecules which demonstrate reduced side effects and extended systemic circulation time, which can ultimately provide greater efficacy. Alternative routes for IFNalpha delivery, such as oral delivery, demonstrate challenging but promising areas of research for improving future patient compliance.