Efficacy of interferon alpha-2b induction therapy before retreatment for chronic hepatitis C

Abstract

For chronic HCV patients who have failed IFN, induction with retreatment does not improve SVR, but may be beneficial for patients with genotype non-1 HCV.

Management of hepatitis C; Report of the Consensus Meeting at the 45th Annual Meeting of the Japan Society of Hepatology (2009)

“…Seven randomized controlled trials have been reported so far that examine the efficacy of PEG‐IFN and RBV combination therapy in patients who failed to respond to previous standard IFN therapy with or without RBV 105–111 . The SVR rate varies among these trials ranging 6–45%, and was lower among non‐responders to previous IFN therapy compared with relapsers.…”

New antiviral therapies for chronic hepatitis C

“…Current data showed that HCV genotype 1 patients who failed the prior standard of care (pegIFN plus RBV for 48 weeks) had a lower chance to achieve SVR when they were treated with the same regimen with or without intensified or prolonged therapy [22][23][24]. It also seems that there was no additional benefit for treatment-naïve HCV genotype 1 patients with intensified therapy, although it was reported that higher rates of SVR were observed among patients C95 kg and those with a NAS (non-alcoholic fatty liver disease activity score) score [3 with induction dosing of pegIFN alpha-2a and/or higher RBV doses [25].…”

Hepatitis C Nonresponders

“…The REPEAT trial by Jensen et al is the first study to evaluate re‐treatment of hepatitis C in a population strictly comprising nonresponders to at least 12 weeks of peginterferon‐α2b and ribavirin. An important shortcoming of previous re‐treatment studies has been heterogeneity in terms of the population (nonresponder versus relapser, genotype 1 versus non‐genotype 1, histologic stages) and the previous treatments (standard interferon monotherapy versus standard interferon + ribavirin versus peginterferon monotherapy) 3–9. The largest contribution of this trial is that it clearly showed the benefit of prolonged therapy in previous nonresponders.…”

“…An important shortcoming of previous re-treatment studies has been heterogeneity in terms of the population (nonresponder versus relapser, genotype 1 versus non-genotype 1, histologic stages) and the previous treatments (standard interferon monotherapy versus standard interferon ϩ ribavirin versus peginterferon monotherapy). [3][4][5][6][7][8][9] The largest contribution of this trial is that it clearly showed the benefit of prolonged therapy in previous nonresponders. Accumulating data in the treatment-naïve patients have shown that in patients who respond slowly (first negative HCV RNA at 24 weeks), 72 weeks of therapy is superior to the standard 48-week-long treatment.…”