Efficacy and cost-effectiveness of consensus interferon monotherapy with high-dose induction for hepatitis C patients with genotype 2.
OBJECTIVE
Several treatment strategies for patients with chronic hepatitis C have been compared mainly in terms of their efficacy, and it has been found that pegylated interferon (IFN) plus ribavirin has become the standard therapy, but aged patients may not tolerate ribavirin and the cost-effectiveness of treatment should also be further considered. We conducted a study to evaluate the efficacy, safety, and cost-effectiveness of consensus IFN monotherapy with high-dose induction for patients with chronic hepatitis C in clinical practice.


METHODS
We consecutively enrolled 104 patients with chronic hepatitis C. Patients were scheduled to receive 12 or 18 μg of consensus IFN daily for 2 weeks, then three times a week for 22 weeks. Efficacy, safety, and cost-effectiveness were assessed. A Markov model was developed to investigate cost-effectiveness in patients with chronic hepatitis C treated by different IFN-based treatment strategies.


RESULTS
Of the 104 study patients, a sustained virological response (SVR) was achieved in 66 (63%). Logistic regression analysis revealed that genotype 2, lower hepatitis C virus RNA levels, and patient age were independently associated with SVR. The response rate was significantly higher in patients with genotype 2 (51/66, 77%) versus genotype 1 (15/38, 40%). Cost-effectiveness analysis in patients with genotype 2 revealed that high-dose induction with consensus IFN monotherapy was as highly cost-effective as pegylated IFN plus ribavirin.


CONCLUSIONS
Consensus IFN monotherapy with high-dose induction shows high efficacy and cost-effectiveness in chronic hepatitis C patients with genotype 2 infection. Thus, it may be a reliable alternative in aged patients and for those excluded from standard combination therapy.
Iwasaki
Yoshiaki
Y
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan. yiwasaki@cc.okayama-u.ac.jp
Tanaka
Hironori
H
Ikeada
Hiroshi
H
Okamoto
Ryo-Ichi
R
Araki
Yasuyuki
Y
Yabushita
Kazuhisa
K
Kobashi
Haruhiko
H
Kariyama
Kazuya
K
Kawaguchi
Mitsuhiko
M
Takaguchi
Kouichi
K
Sakata
Tatsuro
T
Ando
Masaharu
M
Sakaguchi
Kohsaku
K
Aoki
Noriaki
N
Shiratori
Yasushi
Y
D003362:Cost-Benefit Analysis; D003663:Decision Trees; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000191:economics* / Q000821:virology; D006801:Humans; D007372:Interferons / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
D007372:Interferons