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Pilot study of triple antiviral therapy for chronic hepatitis C in interferon alpha non-responders
S Brillanti1, M Foli, M Di Tomaso
1Department of Internal Medicine and Gastroenterology, Policlinico S. Orsola, University of Bologna, Italy. sbrillanti@csi.com
Background:
No effective therapy exists for interferon non-responding chronic hepatitis C patients.
Aims:
Pilot study evaluating the potential efficacy and safety of triple antiviral therapy in interferon-alpha non-responders.
Patients And Methods:
Twenty consecutive adult patients with chronic hepatitis C who had failed to respond to a 6-month course of interferon alpha were randomly assigned to receive a combination of interferon alpha + oral ribavirin (double therapy), or the same combination + oral amantadine (triple therapy), for 6 months.
Results:
By the end of therapy, normal alanine transaminase (biochemical response) was obtained in 2 out of 10 patients on double therapy but in 7 out of 10 on triple therapy (p < 0.05), and negative serum hepatitis C virus (HCV) RNA (virological response) occurred in 1 out of 10 patients on double therapy but in 7 out of 10 patients on triple therapy (p < 0.01). Six months after therapy, biochemical response was sustained in 1 (double therapy) and 4 patients (triple therapy), respectively, and the virological response was sustained in no patient on double therapy but in 3 patients on triple therapy.
Conclusions:
Triple antiviral therapy seems to be able to induce biochemical and virological responses in interferon alpha non-responders with chronic hepatitis C.
Insights
Triple antiviral therapy shows promise for chronic hepatitis C patients who did not respond to interferon alpha. This combination therapy improved biochemical and virological responses, offering a potential new treatment option.
Area of Science:
- Hepatology
- Virology
- Pharmacology
Background:
- Chronic hepatitis C lacks effective therapies for patients unresponsive to interferon.
- Interferon alpha is a standard treatment, but non-response rates are significant.
Purpose of the Study:
- To evaluate the efficacy and safety of triple antiviral therapy.
- To assess the potential of combining interferon alpha, ribavirin, and amantadine in non-responders.
Main Methods:
- A pilot study involving 20 adult patients with chronic hepatitis C.
- Patients were randomized to double therapy (interferon alpha + ribavirin) or triple therapy (interferon alpha + ribavirin + amantadine) for 6 months.
Main Results:
- Triple therapy significantly increased biochemical and virological response rates compared to double therapy.
- Sustained responses were observed in a higher proportion of patients receiving triple therapy post-treatment.
Conclusions:
- Triple antiviral therapy demonstrates potential for treating interferon non-responders.
- This approach may offer a viable treatment strategy for difficult-to-treat chronic hepatitis C cases.