While interferon (IFN) therapy is approved for patients with chronic hepatitis C infection, the effectiveness of IFN therapy for anti-hepatitis C virus (HCV)-positive individuals with normal ALT levels remains poorly understood. Twenty-five individuals (M:F = 9:16; age = 51.8 +/- 15.1 years) who showed a normal alanine aminotransferase (ALT) level (< 30 IU/L) at least 6 months before treatment and were positive for both anti-HCV and serum HCV-RNA by reverse transcription polymerase chain reaction (RT-PCR) were studied. Of these, 16 received IFN therapy for 24 weeks (780 million units total IFN-alpha 2b) and nine were followed for 12 months as controls. The serum HCV-RNA level was determined by bDNA assay and HCV genotype was detected by enzyme immunoassay. All were shown to have chronic hepatitis by liver biopsy. Six (37.5%) of 16 individuals lost serum HCV-RNA by RT-PCR 6 months after cessation of therapy (complete response; CR), while the remaining individuals were defined as non-responders (NR). Of the six individuals in the CR group, five had HCV type 2 infection, compared with none of 10 individuals in the NR group (P < 0.01). There was a trend towards a lower pretreatment viraemia level in the CR group than in the NR group. These data suggest that IFN therapy for individuals with HCV type 2 infection and normal ALT levels was effective.