Combination of interferon induction therapy and ribavirin in chronic hepatitis C

The initial clearance of hepatitis C virus (HCV) during interferon-alfa the rapy is dose-dependent. Therefore, higher initial interferon doses (inducti on therapy) may improve treatment results. This concept was tested in a pro spective, randomized controlled trial. Previously untreated patients with c hronic hepatitis C were randomized to receive 3 different interferon doses during the first 14 weeks of therapy (Group A, n = 130: 10 MU IntronA [AESC A-Schering Plough, Traiskirchen, Austria]/day for 2 weeks, followed by 10 M U/2 days for 12 weeks; Group B, n = 124: 5 MU/day for 14 weeks; Group C, n = 119; 5 MU/2 days for 14 weeks) followed in all by 5 MU/2 days for 24 week s. Throughout the whole study all patients received 1 to 1.2 g ribavirin/da y. On treatment, no differences in viral clearance rates were observed. Sus tained response rates were also not different among the groups (A: 48.5%, B and C: 41.3%, intent to treat). When data were analyzed according to genot ypes, sustained response was almost twice as high in patients with genotype I receiving high-dose interferon induction therapy (A: 44.2%, B: 28.6%, C: 27%, P < .05). In contrast, results were not different in genotype 3a pati ents (A: 61.3%, B: 75.9%, C: 56.3%; P > .1). These data indicate that high- dose interferon induction therapy may improve the outcome of interferon/rib avirin combination therapy in genotype 1 patients.