Sustained response to combination therapy in patients with chronic hepatitis C who failed to respond to interferon.
J Hepatol
; 38(4): 499-505, 2003 Apr.
Article
em En
| MEDLINE
| ID: mdl-12663243
ABSTRACT
BACKGROUND/AIMS:
The best treatment for chronic hepatitis C patients who do not respond to interferon is still unknown. Reported rates of response to treatment vary as the result of heterogeneous definitions of non-responders and small study size.METHODS:
One hundred nineteen hepatitis C virus (HCV) RNA-positive non-responders to high-dose interferon monotherapy received alpha-interferon, 5 MU tiw plus oral ribavirin, 1000-1200 mg/day for 48 weeks (Group A, n=74) or alpha-interferon, 5 MU daily for 4 weeks, followed by 5 MU tiw plus oral ribavirin, 1000-1200 mg/day for 44 weeks (Group B, n=45) according to the Institution where they were followed. Persistently normal alanine aminotransferase and negative HCV RNA up to 72 weeks from treatment onset defined a sustained response.RESULTS:
Eighteen patients discontinued treatment (13 developed anemia, two mucositis, one granulocytopenia; two were dropouts), none for serious adverse events. There were 24 (20%) sustained responders, with similar final response rates in Groups A and B. Sustained response was more frequent in patients aged =40 years (36% vs. 13%; P=0.006) and in those with non-1 genotype (44% vs. 14%; P=0.002). Among genotype 1 patients, the younger ones showed higher response rates (32% vs. 7%; P=0.005). Compared with patients harboring non-1 genotypes, the odds ratio of being a non-responder was 1.68 (confidence interval (CI) 0.53-5.37; P=0.381) in younger genotype 1 patients and 9.53 (CI 2.84-32; P<0.001) in older genotype 1 patients.CONCLUSIONS:
Chronic hepatitis C patients who are non-responders to interferon monotherapy and infected by non-1 genotypes should undergo re-treatment with combination therapy. Treatment should be extended to younger genotype 1 patients who are more susceptible to liver disease worsening because of longer life expectancy and have a higher probability of being long lasting responders than their older counterparts.
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Base de dados:
MEDLINE
Assunto principal:
Antivirais
/
Ribavirina
/
Interferon-alfa
/
Hepacivirus
/
Hepatite C Crônica
Idioma:
En
Ano de publicação:
2003
Tipo de documento:
Article