title: A prospective study on treatment of chronic hepatitis C with tailored and extended interferon-alpha regimens according to pretreatment virological factors.
abstract: 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.
authors.affiliation: Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan, ROC.
authors.forename: Ming-Lung
authors.initials: ML
authors.lastname: Yu
authors.forename: Chia-Yen
authors.initials: CY
authors.lastname: Dai
authors.forename: Shinn-Cherng
authors.initials: SC
authors.lastname: Chen
authors.forename: Li-Po
authors.initials: LP
authors.lastname: Lee
authors.forename: Jee-Fu
authors.initials: JF
authors.lastname: Huang
authors.forename: Zu-Yau
authors.initials: ZY
authors.lastname: Lin
authors.forename: Ming-Yuh
authors.initials: MY
authors.lastname: Hsieh
authors.forename: Liang-Yen
authors.initials: LY
authors.lastname: Wang
authors.forename: Wan-Long
authors.initials: WL
authors.lastname: Chuang
authors.forename: Wen-Yu
authors.initials: WY
authors.lastname: Chang
mesh_terms: 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
chemical_list: D016898:Interferon-alpha; D012367:RNA, Viral