A prospective study on treatment of chronic hepatitis C with tailored and extended interferon-alpha regimens according to pretreatment virological factors.
Hepatitis C virus genotype and viral loads are important predictors for sustained virologic response (SVR) to interferon-alpha therapy for chronic hepatitis C (CHC). We have conducted a prospective study on treatment of 90 patients with a tailored-dose and extended interferon-alpha regimen according to pretreatment virologic factors (low-risk, genotype non-1b/viral < or =0.65 Meq./ml, 6 million units thrice weekly for 12 weeks (6 MU x 12 weeks) followed by 3 MU weeks; high-risk, genotype 1b/viral >0.65 Meq./ml, 6 MU X 24 weeks followed by 3 MU X 24 weeks; medium-risk, the others, 6 MU X 12 weeks followed by 3 MU X 36 weeks), and compared to 123 patients with fixed-dose regimen (6 MU X 24 weeks). Patients with tailored-dose regimen had a significantly higher rate of SVR than those receiving fixed-dose interferon-alpha (46.7% versus 29.3%, P <0.01, intention-to-treat analysis). Improved efficacy was mainly seen in the medium-risk (48.9% versus 26.6%, P=0.02) and the high-risk groups (26.1% versus 8.3%, P=0.06), but not in the low-risk group. By using multivariate logistic regression, low pretreatment viral loads and tailored-dose IFN regimens were significantly associated with higher SVR in both the high- and medium-risk groups. There were no differences in the tolerability and in the incidence of adverse effects between fixed-dose and tailored-dose groups. In conclusion, our results demonstrate the efficacy of tailored-dose interferon-alpha therapy for CHC; these could provide decision-making information for standard/pegylated interferon-alpha combining ribavirin therapy according to baseline predictors.
Yu
Ming-Lung
ML
Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan, ROC.
Dai
Chia-Yen
CY
Chen
Shinn-Cherng
SC
Lee
Li-Po
LP
Huang
Jee-Fu
JF
Lin
Zu-Yau
ZY
Hsieh
Ming-Yuh
MY
Wang
Liang-Yen
LY
Chuang
Wan-Long
WL
Chang
Wen-Yu
WY
D000328:Adult; D005260:Female; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D013997:Time Factors; D019562:Viral Load
D016898:Interferon-alpha; D012367:RNA, Viral