Retreatment of interferon relapse patients with chronic hepatitis C

Abstract

NTERFFIRON has for many years been the established I therapeutic agent for the treatment of chronic hepatitis C. Response rates to interferon therapy vary according to the agent being used, the dose regimen, and the baseline characteristics of the patient population. In studies in which a 6-month regimen was used, biochemical End-of-Treatment Response (ETR) rates have varied from 35% to 50%, and biochemical Sustained Response (SR) rates 6 months after therapy ranged from 8% to 21%. Virologic ETR rates ranged from 27% to 35% and virologic SR rates 6 months after interferon varied from 8% to 12%. In studies of a 12month course of interferon, biochemical ETR rates were not different from those of 6-month courses, but the SR increased from 19% to 42%, almost double that reported with a 6-month course of treatment. These results indicated that therapy prolonged to 12 months increased the SR rate and diminished the relapse rate (1, 2). Different studies and a meta-analysis of randomized trials have demonstrated that the most effective regimen for initial therapy of chronic hepatitis C was 3 MU of interferon three times weekly (TIW) for at least 12 months. This was the therapy recommended by the NIH Consensus Conference on the Management of Hepatitis C held in Bethesda in 1997 (1). Retreatment studies have been performed in patients who have received interferon and have responded to an initial course of therapy but relapsed after the treatment was discontinued. We analyzed the published studies on the retreatment of chronic hepatitis C with different types of interferon, especially with alpha interferon and compared the results with those obtained from combination therapy, interferon plus ribavirin, in order to address the issue of retreatment in relapse patients.