title: Treatment of chronic hepatitis C in patients unresponsive to interferon. Interest of re-treatment combining interferon induction therapy and ribavirin (a multicenter pilot study).
abstract: OBJECTIVE
  About 45% of patients with chronic hepatitis C are unresponsive to the present reference treatment combining pegelated interferon plus ribavirin; before pegylated interferon was available the non-response rate was around 60%. This open multicenter pilot study, initiated before pegylated interferon became available, was designed to evaluate, in patients unresponsive to interferon monotherapy, the rate of biological and virological response and side-effects of the ribivirin-alpha 2b interferon combination.
  
  
  METHODS
  The combination protocol was ribavirin (1 to 1.2 g/d) plus alpha 2b interferon at induction doses (9 MU/d the first week; 4.5 MU/d the eleven following weeks; 3 MU/2 days the 36 following weeks).
  
  
  RESULTS
  Among the 27 included patients, 17 (63%) were viremia-negative (PCR) after 12 weeks of treatment, 9 (33%) were complete responders (undetectable viremia and normal transaminases) at the end of treatment (48 weeks) and of follow-up (72 weeks). Patients with non-1, non-4 genotypes who derived full benefit from this therapeutic strategy (6/7 (86%) were complete responders: 4/5 with genotype 3 and 2/2 with genotype 5). Quality-of-life was impaired during treatment, especially during the first 12 weeks of high-dose interferon therapy.
  
  
  CONCLUSIONS
  While waiting for new therapeutic possibilities, these good results suggest interferon induction at the beginning of treatment remains a valid option.
authors.affiliation: Service d'Hépato-Gastroentérologie, CHR La Source, BP 6709, 45067 Orléans Cedex 2. xavier.causse@chr-orleans.fr
authors.forename: Xavier
authors.initials: X
authors.lastname: Causse
authors.forename: Si Nafa
authors.initials: SN
authors.lastname: Si Ahmed
authors.forename: Jacques
authors.initials: J
authors.lastname: Gros
authors.forename: Veronique
authors.initials: V
authors.lastname: Loustaud-Ratti
authors.forename: Yannick
authors.initials: Y
authors.lastname: Bacq
authors.forename: Armand
authors.initials: A
authors.lastname: Abergel
authors.forename: Christine
authors.initials: C
authors.lastname: Silvain
authors.forename: Pascal
authors.initials: P
authors.lastname: Veillon
authors.forename: Damien
authors.initials: D
authors.lastname: Labarriere
authors.forename: Bruno
authors.initials: B
authors.lastname: Giraudeau
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011994:Recombinant Proteins; D019233:Retreatment; D012254:Ribavirin / Q000627:therapeutic use*; D017211:Treatment Failure
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin