INTERFERON-ALPHA WITH RIBAVIRIN FOR THE TREATMENT OF CHRONIC HEPATITIS-C IN NONRESPONDERS OR RELAPSERS TO INTERFERON MONOTHERAPY

Background: A more effective therapy for chronic hepatitis C virus-inf ected patients is needed, Aim: To evaluate the efficacy, tolerance and timing of response to interferon alpha plus ribavirin in 60 patients with no response or reactivation after interferon alpha alone. Methods : Sixty patients, 42 non-responders and 18 relapsers, received 3 milli on units three times weekly of interferon alpha-2b plus 1-1.2 g ribavi rin daily, for 6 months. Basal biochemical and virological (HCV RNA an d genotype) parameters were determined, Clinical examination, recordin g adverse effects, and laboratory tests, including viraemia, were carr ied out at 1, 2, 3 and 6 months. Results: A significant (P < 0.001) pr ogressive decrease of HCV RNA and alanine transaminase (ALT) levels wa s observed during treatment. On finalizing the sixth month, 42 patient s (70%) had normal ALT and 26 (43.3%) were HCV RNA negative, Of these 26 complete responders, in 20 the viraemia was undetectable by the thi rd month, while a late clearance at the sixth month of treatment was o bserved in six patients, Response rates were higher in previous respon ders to interferon alone (P < 0.05), Mild adverse effects appeared in 46 patients (79.6%), but only three were withdrawn due to serious side -effects. Significantly (P < 0.001), haemoglobin and leucocytes decrea sed, and bilirubin, ferritin and uric acid increased in the first mont h of treatment, with no changes thereafter.Conclusions: Interferon alp ha plus ribavirin progressively decreased HCV RNA and ALT levels, achi eving a complete response in the six months of treatment in 26 (43.3%) patients, This combined therapy was well tolerated.