Interferon-alpha-2b and ribavirin for retreatment of chronic hepatitis C.
OBJECTIVE
Subjects with chronic hepatitis C who fail treatment with interferon-alpha are generally divided into two groups: "relapsers" who normalized serum aminotransferase activity and have undetectable viral RNA during treatment and "non-responders" who do not achieve these results. The aim of this study was to examine retreatment of such subjects.


METHODS
We studied 117 subjects with chronic hepatitis C who failed treatment with interferon-alpha, 87 of whom were "non-responders" and 30 "relapsers." Retreatment was with either interferon-alpha-2b plus ribavirin for 48 weeks or with interferon-alpha-2b plus placebo for 24 weeks followed by 24 weeks of combined therapy.


RESULTS
Sustained response rates, defined as undetectable viral RNA in serum 6 months after retreatment, were 53% in "relapsers" and 10% in "non-responders" (P < 0.005). There was no significant difference if ribavirin was given for 24 or 48 weeks. In "non-responders" infected with genotypes other than type 1, 42% achieved a sustained response compared to 5% infected with genotype 1 (P = 0.027; odds ratio 7.09).


CONCLUSIONS
Treatment with interferon-alpha-2b plus ribavirin is effective in approximately 50% of "relapsers" and "non-responders" infected with non-type 1 genotypes of hepatitis C virus. This therapy is only marginally effective in "non-responders" infected with genotype 1a or 1b.
Dettmer
Robert M
RM
Departments of Medicine, College of Physicians and Surgeons of Columbia University, New York Presbyterian Hospital Columbia-Presbyterian Center, New York, NY 10032, USA.
Reinus
John F
JF
Clain
David J
DJ
Aytaman
Ayse
A
Levendoglu
Hulya
H
Bloom
Alan A
AA
Isaacson
Mary P
MP
Spinnell
Mitchel
M
Meyer
Douglas
D
Sarabanchong
Viyada
V
Zhang
Yatian
Y
Garcia-Carrasquillo
Reuben J
RJ
Markowitz
David D
DD
Magun
Arthur M
AM
Worman
Howard J
HJ
D000328:Adult; D000368:Aged; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000032:analysis; D011994:Recombinant Proteins; D019233:Retreatment; D012254:Ribavirin / Q000627:therapeutic use*
D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D012254:Ribavirin