Panel: Early treatment of HCV not clear-cut
Many patients clear infection on their own
A National Institute of Health expert panel has concluded that there’s not enough evidence to support a recommendation for early treatment of hepatitis C.
A study of 44 patients with acute hepatitis C published last year raised hopes for early treatment when 98% of the patients cleared their infection.1 However, acute hepatitis C may resolve spontaneously in as many as 45% of cases.2
Because of the significant side effects of the interferon, some HCV experts prefer to wait to see if the infection will resolve on its own.
In a preliminary statement issued on June 12, the NIH Consensus Development Conference on Management of Hepatitis C stated: "Evidence- based proof is needed to determine whom to treat and when to start therapy. Delays in treatment for two to three months seem reasonable to identify cases that spontaneously resolve. Weekly monotherapy with PEG-interferon should be studied."
Occupational health professionals should defer to specialists to determine the best course of treatment when a new case of HCV infection is detected, says Miriam J. Alter, PhD, acting associate director for epidemiology and public health in the division of viral hepatitis at the Centers for Disease Control and Prevention in Atlanta.
References
1. Jaeckel E, Cornberg M, Wedemeyer H, et al. Treatment of acute hepatitis C with interferon alfa-2b. N Engl J Med 2001; 345:1,452-1,457.
2. Seeff LB. Natural history of chronic hepatitis C. NIH Consensus Statement: Speaker abstracts. June 12, 2002.
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