High-dose interferon-α2b induction therapy in combination with ribavirin for treatment of chronic hepatitis C in patients with non-response or relapse after interferon-a monotherapy

作     者：Holger G. Hass Christian Kreysel Johannes Fischinger Josef Menzel Stephan Kaiser 

作者机构：Department of Gastroenterology and Hepatology University of Tuebingen Germany Department of Gastroenterology Klinikum Krefeld Germany Department of Gastroenterology and Hepatology University of Saarland Germany Department of Gastroenterology and Hepatology University of Muenster Germany 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2005年第11卷第34期

页      面：5342-5346页

核心收录：

学科分类：1007[医学-药学(可授医学、理学学位)] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100401[医学-流行病与卫生统计学] 10[医学] 

主　　题：干扰素-α2b 用药剂量 病毒唑 慢性丙型肝炎 

摘      要：AIM: To evaluate the daily high-dose induction therapy with interferon-α2b (IFN-α2b) in combination with ribavirin for the treatment of patients who failed with interferon monotherapy and had a relapse, based on the assumption that the viral burden would decline faster, thus increasing the likelihood of higher response rates in this diffficult-to-treat patient ***: Seventy patients were enrolled in this *** was started with 10 MU IFN-α2b daily for 3 wk,followed by IFN-α2b 5 MU/TIW in combination with ribavirin (1 000-1 200 mg/d) for 21 wk. In case of a negative HCV RNA PCR, treatment was continued until wk 48 (IFN-α2b 3 MU/TIW+1 000-1 200 mg ribavirin/daily).RESULTS: The dose of IFN-α2b or ribavirin was reduced in 16% of patients because of hematologic side effects,and treatment was discontinued in 7% of patients. An early viral response (EVR) was achieved in 60% of patients. Fifty percent of all patients achieved an end-of-treatment response (EOT) and 40% obtained a sustained viral response (SVR). Patients with no response had a significantly lower response rate than those with a former relapse (SVR 30% vs 53%; P = 0.049). Furthermore,lower response rates were observed in patients infected with genotype 1a/b than in patients with non-1-genotype (SVR 28% vs74%; P= 0.001). As a significant predictive factor for a sustained response, a rapid initial decline of HCV RNA could be identified. No patient achieving a negative HCV-RNA PCR at wk 18 or later eventually eliminated the ***: Daily high-dose induction therapy with interferon-α2b is well tolerated and effective for the treatment of non-responders and relapsers, when interferon monotherapy fails. A fast decline of viral load during the first 12 wk is strongly associated with a sustained viral response.