ABILITY OF PROLONGED INTERFERON TREATMENT TO SUPPRESS RELAPSE AFTER CESSATION OF THERAPY IN PATIENTS WITH CHRONIC HEPATITIS-C - A MULTICENTER RANDOMIZED CONTROLLED TRIAL
A. Kasahara et al., ABILITY OF PROLONGED INTERFERON TREATMENT TO SUPPRESS RELAPSE AFTER CESSATION OF THERAPY IN PATIENTS WITH CHRONIC HEPATITIS-C - A MULTICENTER RANDOMIZED CONTROLLED TRIAL, Hepatology, 21(2), 1995, pp. 291-297
The aim of this study was to determine whether 12 months course of int
erferon alfa (IFN-alpha) therapy could improve the beneficial effect o
f IFN in chronic hepatitis C. Eighty-eight patients were treated with
natural IFN-alpha for either 28 weeks (45 cases) or 52 weeks (43 cases
). Sustained response was achieved in 15 (33.3%) of 45 cases treated f
or 28 weeks and in 23 (53.5%) of 43 cases treated for 52 weeks. Transi
ent response with relapse of alanine transaminase (ALT) after completi
on of therapy was observed in 13 cases (28.9%) treated for 28 weeks an
d in 4 cases (9.3%) treated for 52 weeks. Thus, ALT relapse was suppre
ssed by prolonged IFN treatment. No response was found in 17 cases (37
.8%) treated for 28 weeks and in 16 cases (37.2%) treated for 52 weeks
, indicating that approximately 38% of the patients with chronic hepat
itis C were resistant to IFN therapy even with prolonged treatment. Th
e rate of sustained response was significantly higher in patients with
type 2a or 2b than in those with type 1b. Even in type 1b cases, it w
as higher in the 52-week treatment group than in the 28-week treatment
group, and the rate of transient response was lower in the 52-week tr
eatment group, indicating that relapse in type 1b cases was suppressed
by prolonged IFN therapy. IFN therapy was not effective for patients
with advanced liver fibrosis. In multivariate regression analysis vira
l genotype and pretreatment level of serum hepatitis C virus (HCV) RNA
were correlated independently with sustained response. Periportal nec
rosis, intralobular inflammation, and hepatic fibrosis scores were sig
nificantly improved in the sustained response group by IFN therapy. In
the transient response group, a significant decrease in scores for in
tralobular inflammation and portal inflammation was observed, whereas
all four histological scores were not improved in the no response grou
p. In conclusion, prolonged IFN therapy can suppress relapse of chroni
c hepatitis C, even in type 1b patients. However, approximately 38% of
the patients are resistant to prolonged IFN therapy, suggesting the n
eed to develop a new therapy.