Prolonged interferon treatment after combination interferon and ribavirin therapy in patients with chronic hepatitis C: A clinical trial of interferon relapsers and non-responders

Background and Purpose: For the retreatment of ch ron ic lie pat it is C pa tients relapsing after, or non-responsive to, previous interferon therapy, the efficacy of combination therapy with interferon alfa plus ribavirin is superior to interferon alone. The aim Of this Study was to determine whethe r prolonged interferon alfa treatment after 24-week combination therapy can Further increase the efficacy of combination therapy. Methods: Nineteen interferon relapsers and 17 interferon non-responders wer e randomly assigned to receive either interferon alfa 5 million units (MU) thrice weekly plus oral ribavirin 1,200 mg daily for 24 weeks (regimen A) O r interferon alfa 5 MU thrice weekly plus oral ribavirin 1,200 mg daily for 24 weeks followed by interferon was assessed alfa 3 MU thrice weekly for a nother 24 weeks (regimen B). Efficacy was assessed by normalization of seru m aminotransferase concentrations and disappearance of serum hepatitis C vi rus (HCV) RNA at the end of treatment and at 24 weeks after stopping treatm ent Results. Overall, 67% of relapsers receiving regimen A and 80% of those rec eiving regimen B had sustained virologic responses 24 weeks after stopping treatment. In contrast, 45% of non-responders receiving regimen A and 63'/C l of those receiving regimen B had sustained responses. The sustained respo nse was more common in relapsers with non-lb HCV genotypes. Tile sustained response rate to combination therapy was 50% or more in patients with genot ype 1b infection. Conclusions: Prolonged interferon treatment after combination therapy has a comparable efficacy to combination therapy alone for the retreatment of ch ronic hepatitis C patient:, relapsing after, or non-responsive to, previous interferon therapy..