Different turnover rate of hepatitis C virus clearance by different treatment regimen using interferon-beta

Background/Aim: Since patients with high viral load and HCV subtype Ib are known to respond poorly to interferon (IFN) therapy, the viral dynamics of HCV RNA after initiation of interferon therapy were examined in the present study with respect to two different administration regimens, once vs. twic e a day. Methods: Twenty-two patients with chronic hepatitis C confirmed by liver bi opsy and with >1 Meq/ml of HCV RNA and HCV subtype Ib were randomly assigne d to two different IFN administration regimens (6 million units of IFN once a day or 3 million units of IFN twice a day), and the serum HCV RNA level was serially measured. Results: Graphs of HCV RNA levels vs treatment time showed an initial rapid fall, followed by a slower clearance phase. Fitting the data to a model fo r HCV decay proposed by Neumann et al, showed that the treatment efficacy w as significantly higher with twice daily administration. Negativity for HCV RNA measured by Amplicor assay in the twice-a-day administration group was 18%, 73% and >89% at 1, 2 and 3 weeks, respectively, in contrast to 0%, 0% , and 18%, respectively, with once-a-day administration. However, a signifi cant reduction of platelet count and albumin level, a marked increase in se rum aspartate aminotransferase/alanine aminotransferase, and a high inciden ce of renal toxicity (proteinuria) were found in patients receiving IFN twi ce a day in comparison with those receiving it once a day, Conclusion: The twice-a-day administration of IFN accelerated the clearance of HCV RNA from serum, leading to a more efficient virological response fo r patients with chronic hepatitis C, but with a high rate of renal toxicity .