Treatment of chronic hepatitis C by interferon for longer duration than six months.
The efficacy of various regimens using interferon-alpha (IFN-alpha) in the treatment of hepatitis C virus (HCV) infection was analyzed in a meta-analysis of 33 randomized clinical trials (RCTs). The results of the meta-analysis showed increased complete and sustained ALT response rates in patients receiving IFN 3 MU three times a week for six months compared with patients receiving placebo or no treatment. The dose effect (6 MU three times a week versus 3 MU three times a week) on complete ALT response rate at the end of treatment was significant, with a mean 10% improvement at both six and 12 months. There also was a significant dose effect on sustained response for 12 months treatment, with a mean 17% improvement. There was a significant treatment duration effect on sustained response rate at 3 MU three times a week and 6 MU three times a week, with a mean improvement of 16% (> or = 12 months vs six months) with 3 MU three times a week. Due to adverse events, we conclude that the best efficacy-risk ratio favors IFN treatment with 3 MU three times a week for at least 12 months. The results of our RCT comparing three IFN regimens showed that patients receiving 3 MU three times a week for up to 18 months exhibited significant improvements in histological activity score, normalization of serum ALT concentrations, and sustained response compared with patients receiving a lower dose or shorter duration of treatment with IFN. Together, these results support the conduct of another RCT to evaluate the hypothesis that long-term, continuous IFN treatment may significantly reduce the incidence of cirrhosis in patients with HCV infection.
Poynard
T
T
Service d'Hépato-Gastroentérologie Groupe Hospitalier Pitié-Salpêtrière, Paris, France.
Leroy
V
V
Mathurin
P
P
Cohard
M
M
Opolon
P
P
Zarski
J P
JP
D002908:Chronic Disease; D004334:Drug Administration Schedule; D006526:Hepatitis C / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage*; D013997:Time Factors; D000637:Transaminases / Q000097:blood
D016898:Interferon-alpha; D000637:Transaminases