TREATMENT OF CHRONIC HEPATITIS-C BY INTERFERON FOR LONGER DURATION THAN 6 MONTHS

The efficacy of various regimens using interferon-alpha (IFN-alpha) in the treatment of hepatitis C virus (HCV) infection was analyzed in a meta-analysis of 33 randomized clinical trials (RCTs). The results of the meta-analysis showed increased complete and sustained ALT response rates in patients receiving IFN 3 MU three times a week for six month s compared with patients receiving placebo or no treatment. The dose e ffect (6 MU three times a week versus 3 MU three times a week) on comp lete ALT response rate at the end of treatment was significant, with a mean 10% improvement at both six and 12 months. There also was a sign ificant dose effect on sustained response for 12 months treatment, wit h a mean 17% improvement. There was a significant treatment duration e ffect on sustained response rate at 3 MU three times a week and 6 MU t hree times a week, with a mean improvement of 16% (greater than or equ al to 12 months vs six months) with 3 MU three times a week. Due to ad verse events, we conclude that the best efficacy-risk ratio favors IFN treatment with 3 MU three times a week for at least 12 months. The re sults of our RCT comparing three IFN regimens showed that patients rec eiving 3 MU three times a week for up to 18 months exhibited significa nt improvements in histological activity score, normalization of serum ALT concentrations, and sustained response compared with patients rec eiving a lower dose or shorter duration of treatment with IFN. Togethe r, these results support the conduct of another RCT to evaluate the hy pothesis that long-term, continuous IFN treatment may significantly re duce the incidence of cirrhosis in patients with HCV infection.