Rapid clearance of hepatitis C virus RNA in peripheral blood mononuclear cells of patients with clotting disorders and chronic hepatitis C treated with alpha-2b interferon is not a predictor for sustained response to treatment.

Thirteen patients with congenital coagulation disorders and chronic hepatitis C were treated with alpha-interferon (IFN). Serum transaminases (ALT) and hepatitis C virus (HCV)-RNA in plasma and peripheral blood mononuclear cells (PBMC) were followed during and after treatment. During IFN treatment ALT levels normalized in 8/13 patients. In all patients HCV-RNA disappeared from PBMC. In 9/13 HCV-RNA also became undetectable from plasma; in six of these nine this occurred earlier in PBMC than in plasma; in the remaining three the disappearance of HCV-RNA occurred simultaneously in plasma and PBMC. All but two patients relapsed within 3 weeks after cessation of IFN, one relapsed after 6 weeks and one patient remains in remission after 6 months. HCV-RNA reappeared either earlier in plasma (3/12) or simultaneously in plasma and PBMC (9/12). Viral replication in PBMC thus can easily be suppressed by IFN, whereas longer treatment is needed for the eradication of HCV-RNA in plasma. The detection of HCV-RNA in PBMC cannot be used as a prognostic marker for the identification of patients with chronic hepatitis C who will have a sustained response to IFN treatment.