Interferon Alfacon-1 and Ribavirin Versus Interferon ?-2b and Ribavirin in the Treatment of Chronic Hepatitis C

Abstract

Despite advances in the therapy of chronic hepatitis C, a large number of patients do not respond to current therapies. The study objective was to assess whether a combination of interferon (IFN) alfacon-1 and ribavirin improves the response rate compared with a combination of INF alpha-2b and ribavirin in chronic hepatitis C subjects. The study was designed as an open-label, prospective, randomized, controlled study; 128 subjects with chronic hepatitis C were randomized to INF alfacon-1, 15 microg three times per week, plus ribavirin, 1 g/day, or IFN-alpha2b, 3 million units three times per week, plus ribavirin, 1 g/day for 48 weeks. The end point of the study was a sustained viral response, defined as undetectable HCV RNA at 24 weeks post 48 weeks of treatment. Overall, 57% of subjects in the INF alfacon-1/ribavirin group achieved a sustained antiviral response, compared with 40% of subjects in the IFN-alpha2b/ribavirin group (P = 0.052). In the subset of subjects with a high viral load, HCV RNA was successfully eradicated in more individuals who received INF alfacon-1/ribavirin than subjects who received IFN-alpha2b/ribavirin (57 versus 31%; P = 0.025). Among individuals with genotype 1 and a high viral load, the sustained antiviral response was significantly higher with INF alfacon-1/ribavirin than with IFN-alpha2b/ribavirin (46 versus 14%; P = 0.019). Adverse events were similar in both treatment groups. In conclusion, this study demonstrated that the combination of INF alfacon-1 and ribavirin provides a significantly better treatment response compared with the combination of IFN-alpha2b and ribavirin in chronic HCV subjects infected with genotype 1 and a high viral RNA load.

Recent IV-drug users with chronic hepatitis C can be efficiently treated with daily high dose induction therapy using consensus interferon: An open-label pilot study

“…This fact might be explained by the small number of patients presenting genotype 1 and low-viral load. Overall, the patients with genotype 1 and high viral load showed an acceptable response rate, which is in accordance to Sjögren et al [11] , showing a higher response rate for this population treated with CIFN and ribavirin instead of pegylated interferon α-2b and ribavirin (46% vs 14%).…”

Consensus Interferon Used to Treat Prior Partial-Responders to Pegylated Interferon Plus Ribavirin

“…The results represent a three to sixfold improvement over the results achieved in prior non-responders utilizing a second course of peg-IFN [4][5][6][7][8][9] and confirm the results of others, who have used c-IFN [24][25][26][27][28][29][30][31][32]. The results are even more noteworthy in that 81% of the patients had a genotype 1 infection, 21% had cirrhosis, and 24% were African American at the initiation of their therapy, factors known to reduce response rates significantly.…”

“…Coincident with the increased response rates has been the recognition of the critical value of ribavirin dosing that should continue throughout the treatment program [21,22] and the identification of critical time points that identify a high likelihood of SVR (no HCV at 4 weeks of therapy) or subsequent failure of therapy (HCV positive after 12 weeks of therapy) [23,24].…”

Management of chronic hepatitis C treatment failures: role of consensus interferon

“…29 Subsequent prospective studies suggested that CIFN may have a signifi cant advantage over standard IFN, particularly for diffi cult-to-treat patients with higher baseline serum HCV RNA levels and those infected with HCV genotype 1. 30,31 The development of PEG IFN alfa-2a and alfa-2b has resulted in the ability to achieve a substantially higher rate of SVR in naïve patients 6,7 and at this time, a pegylated formulation of CIFN is not available. Although one recent study revealed that CIFN 3 times weekly in combination with weight-based RBV may be as effective as combination PEG IFN alfa-2b and weight-based RBV in the treatment of HCV genotype 1 patients, comparative data are limited.…”