Prospective study of a high-intensity interferon-alpha regimen for chronic hepatitis C virus genotype 1b infection.
OBJECTIVE
To evaluate efficacy of high-intensity interferon administration for patients chronically infected with hepatitis C virus genotype 1b, we administered interferon-alpha with different regimens according to viral load.


METHODS
Eighty-eight patients with hepatitis C virus genotype 1b were treated with recombinant interferon alpha-2b. The 70 patients with pretreatment hepatitis C virus RNA concentration > or = 10(6) copies/mL were given 10(7) units of interferon daily for the first 8 weeks and then three times weekly for 16 weeks (group A). The 18 patients with smaller pretreatment hepatitis C virus RNA concentration received the same dose daily for the first 2 weeks and then three times weekly for 14 weeks (group B). We analyzed tolerance of therapy, responses, and long-term outcome in the two groups.


RESULTS
Fifteen of 70 patients (21.4%) in group A could not continue treatment and dropped out, while all patients in group B completed the entire course of therapy. The rate of sustained response in group A was 10.0%, being significantly less than in group B (72.2%; p < 0.0001). However, 12 patients in group A showed a biochemical sustained response despite presence of viremia. Long-term outcome did not differ between groups.


CONCLUSIONS
Many patients could not tolerate high-intensity therapy, which showed the limitation of tolerance of patients receiving interferon monotherapy. High-intensity therapy could not improve eradication of hepatitis C virus in patients with high pretreatment hepatitis C virus RNA concentration. However, this therapy may increase the rate of sustained biochemical response, improving long-term outcome.
Toyoda
Hidenori
H
Department of Gastroenterology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu, 503-8502 Japan.
Kumada
Takashi
T
Nakano
Satoshi
S
Takeda
Isao
I
Sugiyama
Keiichi
K
Kiriyama
Seiki
S
Tanikawa
Makoto
M
Sone
Yasuhiro
Y
Hisanaga
Yasuhiro
Y
Hayashi
Kazuhiko
K
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000821:virology; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000821:virology; D008113:Liver Neoplasms / Q000821:virology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D011994:Recombinant Proteins; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins