Retreatment of non-responder or relapser chronic hepatitis C patients withinterferon plus ribavirin vs interferon alone

Background and Aim. Interferon-alpha treatment of chronic hepatitis C is be neficial in only 20-30% of patients. This study evaluates if combination th erapy with Interferon-alfa plus ribavirin is effective in inducing a respon se in patients who did nor respond to, or relapsed after a standard Interfe ron-alfa treatment. Patients and Methods. A total of 88 patients, 49 non-responders and 39 rela psers to previous interferon-alfa therapy, were randomized to receive eithe r natural Interferon-alfa (6 MU t.i.w.) phs ribavirin (1000 mg/daily) or na tural Interferon-alfa alone (6 MU t.i.w.)for 6 months. All were followed fo r 12 months after stopping therapy. Serum aminotransferase levels were asse ssed monthly and HCV RNA was evaluated by RT-PCR (Amplicor; Roche) at end o f therapy and the end of follow-up. Results, After treatment, a higher response rate defined as return to norma l of aminotransferases and absence of serum HCV RNA was observed among pati ents treated with Interferon-alfa-ribavirin: 4/28 (14%) vs 1/21 (5%) non-re sponder patients and 9/19 (47%) vs 5/20 (25%) in the relapsers group. At th e end of follow-up, a sustained response was found only in the combination treatment group: 4% and 32% in non-responder and relapser patients, respect ively. Conclusions. Our results suggest that retreatment with natural Interferon-a lfa plus ribavirin is more effective than Interferon-alfa alone in increasi ng the response rate in patients with chronic hepatitis C who relapse after a previous standard IFN treatment whereas it is less effective in non-resp onder patients.