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High initial dose combination regimen with interferon-alpha and ribavirin in chronic hepatitis C
Iskren Kotzev1, Irina Ivanova, Maria Atanassova
1Department of Internal Medicine, Clinic of Hepatogastroenterology, University Hospital St. Marina, 1 Hristo Smirnenski Str., Varna 9010, Bulgaria. iskren@mail.vega.bg
Background/Aims:
Combination of interferon-alpha and ribavirin becomes the antiviral therapy of choice for chronic hepatitis C. The aim of this trial was to assess the efficacy of two combination treatment strategies: standard regimen Interferon-alpha 3 MU three times per week (group A) and initial high dose Interferon 6 MU daily for 2 weeks followed by intermittent administration 3 MU three times per week (group B), plus Ribavirin in naive and relapsed patients with chronic hepatitis C.
Methodology:
Twenty-four patients (group A, 6; group B, 18) received medication for median 6 months (range, 5-12) and followed for 6 months. Primary end-point of therapy was a sustained virologic response. Statistical analysis was performed with a t test or non-parametric Mann-Whitney and chi-square test.
Results:
At the end of the follow-up the overall sustained response rate was 42%: 6 of 18 (33.3%) patients with induction and 4 of 6 (66.6%) with standard regimen. Patients with sustained virologic response received higher interferon dose (423.7 +/- 102.2 MU) at extended duration of therapy (9.8 +/- 2.9 months) versus patients with non-sustained response (p < 0.05). The difference in sustained response rate in both treatment regimens was nonsignificant.
Conclusions:
High initial dose therapy does not enhance virologic response, compared to standard combination regimen.