title: Impact of high-dose interferon induction and ribavirin therapy in patients with chronic hepatitis C relapsing after or not responding to interferon monotherapy.
abstract: OBJECTIVE
  Initial high-dose interferon-alpha induction therapy in combination with ribavirin improves sustained response rates in treatment-naïve patients. This prospective, randomized, controlled study tested whether non-responders or relapsers to interferon monotherapy also benefit from induction therapy.
  
  
  METHODS
  Patients with chronic hepatitis C who had not responded to (n=75) or relapsed (n=80) after previous interferon therapy were randomized to receive three different interferon doses during the first 14 weeks of therapy (A: 10 MU IntronA/day for 2 weeks, followed by 10 MU/2 days for 12 weeks; B:5 MU/d for 14 weeks; C: 5 MU/2 days for 14 weeks) followed in all by 5 MU/2 days for 24 weeks. All patients received 1-1.2 g ribavirin/day throughout the whole study.
  
  
  RESULTS
  The rates of viral clearance at any time on treatment were similar in all groups. Sustained response rates were also not different among the groups in interferon nonresponders (A 32%, B 29%, C 31%) and relapsers (A 64%, B 68%, C 71%), respectively, as well as in patients with different genotypes. As expected, sustained response rates were higher in patients with genotype non-1 than in those with genotype 1.
  
  
  CONCLUSIONS
  High-dose induction therapy does not improve the outcome of interferon/ribavirin therapy in interferon nonresponders or relapsers.
authors.affiliation: Department of Internal Medicine IV, Gastroenterology and Hepatology, University of Vienna, Austria. petra.munda@akh-wien.ac.at
authors.forename: Petra
authors.initials: P
authors.lastname: Steindl-Munda
authors.forename: Peter
authors.initials: P
authors.lastname: Ferenci
authors.forename: Harald
authors.initials: H
authors.lastname: Brunner
authors.forename: Karin
authors.initials: K
authors.lastname: Nachbaur
authors.forename: Christian
authors.initials: C
authors.lastname: Datz
authors.forename: Michael
authors.initials: M
authors.lastname: Gschwantler
authors.forename: Harald
authors.initials: H
authors.lastname: Hofer
authors.forename: Rudolf
authors.initials: R
authors.lastname: Stauber
authors.forename: Franz
authors.initials: F
authors.lastname: Hackl
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Jessner
authors.forename: Martha
authors.initials: M
authors.lastname: Rosenbeiger
authors.forename: Alfred
authors.initials: A
authors.lastname: Gangl
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Vogel
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D024882:Drug Resistance, Viral / Q000187:drug effects*; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007279:Injections, Subcutaneous; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012008:Recurrence; D019233:Retreatment; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D012254:Ribavirin