Interferon-alpha plus ribavirin for 12 months increases the sustained response rates in chronic hepatitis C relapsers.
BACKGROUND
The effectiveness and tolerability of combination therapy for 12 months have not been evaluated sufficiently in chronic hepatitis C relapsers to interferon.


OBJECTIVE
To evaluate the sustained response to interferon plus ribavirin for 12 months in chronic hepatitis C relapsers.


METHODS
We included 55 chronic hepatitis C relapsers in a 12-month treatment protocol with interferon (3 MU thrice weekly) plus ribavirin (1-1.2 g/day). The effectiveness was evaluated using serum aminotransferase and hepatitis C virus RNA levels, alanine aminotransferase normalization and viraemia clearance after 12 months, defining the end-of-treatment response, and 6 months after completion of therapy, defining the sustained response. Adverse effects were recorded.


RESULTS
End-of-treatment response and sustained response were achieved in 47 (85%) and 37 (67%) patients, respectively; there were 10 (21%) relapsers after combination therapy. Predictive factors of sustained response included the genotype (non-1 95% vs. 1 48%; P < 0.001), lower viraemia (503 917 +/- 553 230 vs. 901 393 +/- 548 267 copies/mL; P < 0.005), higher alanine aminotransferase levels (137 +/- 75 vs. 103 +/- 41 IU/L; P < 0.05) and a lower gamma-glutamyl transpeptidase/alanine aminotransferase ratio (0.30 +/- 0.23 vs. 0.49 +/- 0.39; P < 0.05). Tolerance to therapy was good, with no withdrawals.


CONCLUSIONS
Interferon plus ribavirin treatment for 12 months in chronic hepatitis C relapsers yields high sustained response rates and is well tolerated. The sustained response is related to a non-1 genotype, lower baseline viraemia, higher alanine aminotransferase level and a lower gamma-glutamyl transpeptidase/alanine aminotransferase ratio.
Moreno-Monteagudo
J A
JA
Liver Unit, Hospital de la Princesa, Autonomous University of Madrid, C/Diego de León 62, 28006 Madrid, Spain.
Castro
A
A
De Pedro
A
A
Lorenzo
J A
JA
Fernández-Bermejo
M
M
Lopez
S
S
García-Buey
L
L
Borque
M J
MJ
Pedreira
J D
JD
Moreno-Otero
R
R
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000209:etiology / Q000235:genetics; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D005723:gamma-Glutamyltransferase / Q000097:blood
D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase