Ability of prolonged interferon treatment to suppress relapse after cessation of therapy in patients with chronic hepatitis C: A multicenter randomized controlled trial

Abstract

The aim of this study was to determine whether 12 months course of interferon alfa (IFN-alpha) therapy could improve the beneficial effect of IFN in chronic hepatitis C. Eighty-eight patients were treated with natural IFN-alpha for either 28 weeks (45 cases) or 52 weeks (43 cases). Sustained response was achieved in 15 (33.3%) of 45 cases treated for 28 weeks and in 23 (53.5%) of 43 cases treated for 52 weeks. Transient response with relapse of alanine transaminase (ALT) after completion of therapy was observed in 13 cases (28.9%) treated for 28 weeks and in 4 cases (9.3%) treated for 52 weeks. Thus, ALT relapse was suppressed by prolonged IFN treatment. No response was found in 17 cases (37.8%) treated for 28 weeks and in 16 cases (37.2%) treated for 52 weeks, indicating that approximately 38% of the patients with chronic hepatitis C were resistant to IFN therapy even with prolonged treatment. The rate of sustained response was significantly higher in patients with type 2a or 2b than in those with type 1b. Even in type 1b cases, it was higher in the 52-week treatment group than in the 28-week treatment group, and the rate of transient response was lower in the 52-week treatment group, indicating that relapse in type 1b cases was suppressed by prolonged IFN therapy. IFN therapy was not effective for patients with advanced liver fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Efficacy of interferons in treating children with chronic hepatitis C

“…The present study as well as our previous study [13] showed that speci®c HCV genotypes are associated with the amount of HCV RNA, the severity of liver disease, and the ecacy of IFN therapy in children, as previously reported in adults [9,19,21]. Findings support the idea that patients with the HCV genotype II (Simmond Ib) [6] are less likely to respond than the HCV genotype III (Simmond 2a), and the more prolonged therapy with IFN may improve the outcome of retreatment after the failure of the initial course of IFN.…”

“…Interferon-a (IFN-a) is up to now the most promising treatment of chronic hepatitis C virus (HCV) infection, however only 10%±33% of adult patients with chronic HCV infection show a sustained complete response after treatment is completed [4,5,9,18]. The rarity of liver cirrhosis and severe chronic active hepatitis (CAH) in children led to the speculation that their response could be better than adults when treated with IFN-a for chronic HCV infection [3,7,13,16].…”

A randomized controlled trial of high-dose maintenance interferon therapy in chronic hepatitis C

“…The virological characteristics tal IFN dose of 468 MU over 6 (28%) or 12 months most consistently predictive of a low likelihood of sus-(31%). The low sustained response rate in our study, as tained response are high levels of pretreatment viremia compared to others [Jouët et al, 1994;Kasahara et al, and infection with HCV type 1, especially 1b [Kanai et 1995], might be due more to the unfavorable features al., 1992; Chemello et al, 1994;Tsubota et al, 1994; of patients than to the actual schedule of treatment. Booth et al, 1993].…”

Efficacy of interferon retreatment after relapse for chronic hepatitis C patients with biochemical response after first interferon therapy

“…Currently, as shown in many studies, interferon (IFN) is the only drug that induces viral clearance and marked biochemical and histological improvement in patients with chronic hepatitis C. [1][2][3][4][5][6][7][8][9][10][11][12] In these many studies, hepatitis C virus (HCV)-RNA clearance rates were reported to be about 30%-40% in patients treated with a course of IFN of less than 6 months. However, with respect to IFN treatment for chronic hepatitis C, normalization of alanine aminotransferase (ALT) as well as clearance of HCV-RNA after IFN therapy is important.…”