title: Interferon-alpha plus ribavirin for 12 months increases the sustained response rates in chronic hepatitis C relapsers.
abstract: 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.
authors.affiliation: Liver Unit, Hospital de la Princesa, Autonomous University of Madrid, C/Diego de León 62, 28006 Madrid, Spain.
authors.forename: J A
authors.initials: JA
authors.lastname: Moreno-Monteagudo
authors.forename: A
authors.initials: A
authors.lastname: Castro
authors.forename: A
authors.initials: A
authors.lastname: De Pedro
authors.forename: J A
authors.initials: JA
authors.lastname: Lorenzo
authors.forename: M
authors.initials: M
authors.lastname: Fernández-Bermejo
authors.forename: S
authors.initials: S
authors.lastname: Lopez
authors.forename: L
authors.initials: L
authors.lastname: García-Buey
authors.forename: M J
authors.initials: MJ
authors.lastname: Borque
authors.forename: J D
authors.initials: JD
authors.lastname: Pedreira
authors.forename: R
authors.initials: R
authors.lastname: Moreno-Otero
mesh_terms: 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
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase