TREATMENT OF CIRRHOTIC HEPATITIS-C VIRUS PATIENTS WITH DAILY DOSES OFINTERFERON-ALPHA(2A)

In patients with hepatitis C who have cirrhosis the rate of sustained response following interferon therapy is less than half that of patien ts without cirrhosis. It has been suggested, however, that a higher do se regime in patients with cirrhosis may improve response. The results of a recent Australian study of cirrhotic patients who were given an intense interferon programme of 4.5 MIU daily for 24 weeks were compar ed with previous studies of patients with hepatitis C. In the Australi an study, 14% of patients had a sustained response at 6 months after e nd of therapy, Of 11 studies of interferon response in chronic hepatit is C comparison of pretreatment variables showed considerable differen ces, Identification of predictors of response by univariate and multiv ariate analysis regularly indicated the importance of age and fibrosis , Analysis of six studies with either a poor (5% or less) or a reasona ble (14-19%) sustained response rate to interferon in patients with ci rrhosis suggested that a higher dose or longer duration of therapy was associated with better results, The experience of the Australian stud y, where 14% of patients had a sustained biochemical response to inter feron and side-effects were reasonably tolerated with careful monitori ng, suggests that future studies in cirrhosis should be carried out ex ploring higher doses and longer durations of therapy.