RETREATMENT OF HEPATITIS C INTERFERON NONRESPONDERS WITH LARGER
DOSES OF INTERFERON WITH AND WITHOUT PHLEBOTOMY
Background/Aims:
Interferon a (IFN) is the only agent currently approved by the FDA
for the treatment of chronic viral hepatitis due to hepatitis C
(HCV). Unfortunately, less than half the patients with HCV treated
with IFN respond. Worse yet, half or more of those who do respond
relapse when the agent is withdrawn.
Materials and Methods:
In this prospective randomized study, 30 individuals who had failed
to respond to a standard course of IFN therapy consisting of 3 MU
IFN administered 3 x week for 6 months were randomized to receive a
second 6 month course of either 5 MU IFN daily or 5 MU IFN plus
regular phlebotomies at weekly intervals to achieve a hemoglobin
level of between 10-11 g/dl. The response rates defined as HCV-RNA
negativity after 6 months of therapy and after 6 months of
follow-up without IFN were determined.
Results:
Both groups experienced a significant reduction in their serum ALT
levels (p <0.01) and Knodell scores with treatment. A greater
number of responders were found in the phlebotomy plus IPN group
than in the IFN alone group whether the response was defined by the
serum ALT level or presence or absence of HCV-RNA in serum at the
end of treatment and follow-up.
Conclusions:
The results of this study suggest that both an increased IFN dose
coupled with more frequent dosing of IFN alone and combined with
phlebotomy treatment are effective at obtaining a response to IFN
in individuals with HCV disease who previously have failed to
respond to a standard treatment regimen.
Author: VANTHIEL DH, UNIV KENTUCKY, TRANSPLANT CTR, 800 ROSE
ST, LEXINGTON, KY 40536
Source: HEPATO-GASTROENTEROLOGY 1996
NOV-DEC;43(12):1557-1561
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