Induction interferon therapy in nave patients with chronic hepatitis C: increased end-of-treatment virological responses but absence of long-term benefit

Background and aims: The low efficacy of interferon monotherapy and data fr om viral kinetic studies led us to evaluate the efficacy of interferon admi nistered daily in chronic hepatitis C. Patients and methods: Thirty-eight naive patients with chronic hepatitis C and active liver disease randomly received 3 or 5 MU IFN-alpha daily for 1 month, followed by the same dose three times a week for 11 months. Results were compared to a three-times-a-week scheme of 3 MU IFN-alpha for 1 year. Results: At the end of the induction period, 27 out of 38 (71%) patients ha d cleared HCV-RNA with a significantly higher rate in the 5 MU than in the 3 MU group (17 out of 18 or 94% vs. 10 out of 20 or 50%, P = 0.003). The en d-of-treatment virological response rate was 66% (25 out of 38) in the indu ction groups and 40% (10 out of 25) in the control group (P = 0.04). Six mo nths after completion of therapy, the sustained response rate dropped to 29 % (11 out of 38) compared to 28% (7 out of 25) in the standard regimen. Conclusions: In chronic hepatitis C, treatment with 5 or 3 MU IFN-alpha dai ly during the first month of a standard IFN regimen leads to significantly increased end-of-treatment virological responses, but long-term responses a re similar to those of standard IFN monotherapy.