A comparison of standard and induction interferon therapy with and without initial ribavirin in treatment na

Peine, Craig J.; Albrecht, Jeffrey H.; Roel, Joseph P.; B, Gundersen; Kirchner, John P.; Zins, Bradley J.; McKee, Daniel P.; Ho, Samuel B.; Smith, Theresa J.

doi:10.1016/s0016-5085(00)81818-1

Cited by 1 publication

(2 citation statements)

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“…Two recent published studies have shown that ETR, but not SVR, is enhanced with higher daily doses of IFN α 2b (5 m U) for one month followed by standard dosing of IFN monotherapy [6,7]. These observations have been supported by several recent preliminary findings using IFN in combination with ribavirin [9,10]. In two studies both ETR and SVR were enhanced with high dose induction therapy with ribavirin [11,12].…”

Section: Discussionmentioning

confidence: 89%

“…Based on viral kinetic studies that indicate higher doses of IFN cause a greater degree of inhibition of viral production and promote more rapid early viral clearance [4,5], it has been proposed that higher initial doses of IFN (induction dosing) may promote an increased rate of early viral clearance, end of treatment response (ETR) and sustained virologic response (SVR). Preliminary results from induction dosing trials have been mixed, with most studies showing greater rates of early viral clearance and ETR but no or little differences in SVR [6–12] . One would predict that more rapid rates of viral clearance would actually lead to a greater rate of SVR as studies have shown that the earlier the virus is cleared from serum the greater the chance of SVR [13–20].…”

Section: Introductionmentioning

confidence: 99%

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Induction therapy with consensus interferon (CIFN) does not improve sustained virologic response in chronic hepatitis C

Layden

Reddy

et al. 2002

Journal of Viral Hepatitis

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In patients infected with hepatitis C virus (HCV) genotype 1, sustained viral response (SVR) averages 10-40% depending on treatment regime. It has been proposed that high dose daily interferon (IFN) therapy early in therapy (induction dosing) may enhance SVR. In the present study we examined this issue and also assessed whether one could predict SVR and non-SVR, based on viral kinetics during the first month of induction therapy. End of treatment response and SVR was determined in 173 HCV infected patients who were treated with different induction doses of consensus interferon (CIFN) for one month followed by 11 months of standard 9 microg of CIFN thrice weekly (TIW). The second phase decline slope was calculated by log-linear regression on weekly measurements of serum HCV RNA during the first 7-28 days of treatment; rapid viral response (RVR) during the first month of induction dosing was defined as a decline of > 0.3 log copies/mL/week. Overall, SVR occurred in 11% of genotype 1 infected patients and 41% of patients with nongenotype 1. High dose induction therapy did not increase the rate of SVR, in either genotype 1 or genotype 2/3 infected patients. No patient without a RVR during the first month had SVR, while SVR occurred in 55% of the patients with RVR. RVR was the best predictor of SVR using multivariate analysis. These results indicate that induction dosing with CIFN does not improve SVR rates. They also suggest that early viral kinetics during the first month of therapy can predict non-SVR and thus save a patient a year long treatment which is fraught with side-effects and significant cost.

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Section: Discussionmentioning

confidence: 89%