TY - JOUR
T1 - Combination of interferon and ribavirin in chronic hepatitis C
T2 - Re-treatment of nonresponders to interferon
AU - Di Bisceglie, Adrian M.
AU - Thompson, Judy
AU - Smith-Wilkaitis, Nancy
AU - Brunt, Elizabeth M.
AU - Bacon, Bruce R.
N1 - Funding Information:
Abbreviations: IFN, interferon; HCV, hepatitis C virus; ALT, alanine transaminase. From the 1Division of Gastroenterology and Hepatology, Department of Internal Medicine; and 2Department of Pathology, Saint Louis University School of Medicine, St Louis, MO. Received August 18, 2000; accepted December 12, 2000. Supported in part by a grant from Schering Plough. Address reprint requests to: Adrian M. Di Bisceglie, M.D., FACP, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Saint Louis University School of Medicine, 1402 South Grand Blvd., St. Louis, MO 63104. E-mail: DIBISCAM@slu.edu; fax: 314-577-8125. Copyright © 2001 by the American Association for the Study of Liver Diseases. 0270-9139/01/3303-0027$35.00/0 doi:10.1053/jhep.2001.22346
PY - 2001
Y1 - 2001
N2 - Chronic infection with hepatitis C virus (HCV) may result in cirrhosis, liver failure, and hepatocellular carcinoma. A minority of patients have a sustained response to antiviral therapy, and nonresponders remain at risk of developing progressive liver disease. We conducted a randomized, controlled trial of therapy with the combination of interferon (IFN) and ribavirin in patients with chronic hepatitis C who had not responded to an initial course of therapy with IFN alone. A total of 124 patients were randomized to receive the combination of IFN and ribavirin for either 24 or 48 weeks and followed for an additional 24 weeks after stopping therapy. Thirty-eight treated patients (30.6%) achieved a sustained virologic response (undetectable HCV RNA at the 24-week follow-up point). This was associated with significant improvement in necroinflammatory activity noted on liver biopsy. Interestingly, there was not a statistically significant difference in response rates based on the duration of treatment; HCV genotype was the strongest predictor of a sustained response. Sustained responses were noted even in patients with poor predictive factors, including those with advanced hepatic fibrosis or cirrhosis, high levels of HCV RNA in serum, and those infected with HCV genotype 1. The study included 24 patients with normal serum alanine transaminase (ALT) values before therapy who had similar responses to those with initially elevated transaminase values. This study suggests that the combination of IFN and ribavirin is a useful modality of therapy in patients with chronic hepatitis C who did not respond to IFN alone.
AB - Chronic infection with hepatitis C virus (HCV) may result in cirrhosis, liver failure, and hepatocellular carcinoma. A minority of patients have a sustained response to antiviral therapy, and nonresponders remain at risk of developing progressive liver disease. We conducted a randomized, controlled trial of therapy with the combination of interferon (IFN) and ribavirin in patients with chronic hepatitis C who had not responded to an initial course of therapy with IFN alone. A total of 124 patients were randomized to receive the combination of IFN and ribavirin for either 24 or 48 weeks and followed for an additional 24 weeks after stopping therapy. Thirty-eight treated patients (30.6%) achieved a sustained virologic response (undetectable HCV RNA at the 24-week follow-up point). This was associated with significant improvement in necroinflammatory activity noted on liver biopsy. Interestingly, there was not a statistically significant difference in response rates based on the duration of treatment; HCV genotype was the strongest predictor of a sustained response. Sustained responses were noted even in patients with poor predictive factors, including those with advanced hepatic fibrosis or cirrhosis, high levels of HCV RNA in serum, and those infected with HCV genotype 1. The study included 24 patients with normal serum alanine transaminase (ALT) values before therapy who had similar responses to those with initially elevated transaminase values. This study suggests that the combination of IFN and ribavirin is a useful modality of therapy in patients with chronic hepatitis C who did not respond to IFN alone.
UR - http://www.scopus.com/inward/record.url?scp=0035120818&partnerID=8YFLogxK
U2 - 10.1053/jhep.2001.22346
DO - 10.1053/jhep.2001.22346
M3 - Article
C2 - 11230751
AN - SCOPUS:0035120818
SN - 0270-9139
VL - 33
SP - 704
EP - 707
JO - Hepatology
JF - Hepatology
IS - 3
ER -