Retreatment of chronic hepatitis C virus infection

Pardo, Margarita; Cotonat, Teresa; Herrero, M. Marín; Marriott, Eduardo; Artillo, Santiago; Quiroga, Juan Antonio; Carréño, Vicente

doi:10.1016/s0140-6736(94)92968-8

Cited by 10 publications

(2 citation statements)

References 2 publications

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“…The high frequency of relapses following treatment is characteristic of interferon therapy for HCV infection [8], and the subsequent management of these patients is a problem. Further temporary responses to interferon can be expected [23], but if long-term control of HCV is the goal, consideration may need to be given to very prolonged treatment. These options may be suitable for those patients in our trial who had partial as well as complete normalization of ALT.…”

Section: Discussionmentioning

confidence: 99%

Alpha interferon for hepatitis C virus infection in haemophilic patients

et al. 1995

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We have conducted a controlled trial in 20 haemophilic patients in which intravenous recombinant interferon alpha-2a, 3 mega units thrice weekly, was used to treat chronic hepatitis C infection. The study endpoints included complete and paritial normalization of serum ALT, and loss of serum HCV RNA as determined by polymerase chain reaction (PCR). Interferon treatment was effective, and resulted in improvement in ALT in nine (45%) and a loss of HCV RNA in five patients (26%), but a sustained normalization of ALT has been seen in only one case. Responses were poor in those with HIV coinfection or with HCV genotype 1 (Simmonds classification). Troublesome side-effects were reported in 80%. The occurrence of a factor VIIIc inhibitor during the study was possibly an autoimmune complication of interferon. In conclusion, we have shown lower response rates than those seen in post-transfusion hepatitis C infection and suspect that current interferon regimes are unlikely to influence the natural history of HCV infection in haemophilia. Consideration should be given to trials of higher dosage interferon, and of long-term maintenance therapy for those who relapse.

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Section: Discussionmentioning

confidence: 99%

Alpha interferon for hepatitis C virus infection in haemophilic patients

et al. 1995

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“…Using serum ALT to assess retreatment, the sustained biochemical complete response rates, using similar doses of IFN as used for the first course of therapy, were in the range of 0 to 30% [11][12][13]. In some of the above reports, it was noted that up to 90% of the patients who were in the ALT responder/relapse category to the first course of IFN therapy also had normalization of serum ALT levels during retreatment, but a majority again relapsed after cessation of therapy [11,12]. When higher doses of IFN were used for retreatment, biochemical response rates of up to 46% were observed [14,15].…”

Section: Discussionmentioning

confidence: 99%

Long‐term retreatment in chronic hepatitis C patients who were non‐responders to an initial course of interferon‐α2b

Tong

Blatt

Tong

et al. 1998

Journal of Viral Hepatitis

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Nineteen patients with chronic hepatitis C who were virological non-responders (seven responder/relapse and 12 no response) to an initial 24-week course of interferon-alpha 2b (IFN-alpha 2b) at a dose of 3 million units (MU) thrice weekly were retreated for an additional 48 weeks at the same dosing schedule and followed-up for another 24 weeks post-therapy. At the end of follow-up (week 72), six (32%) of the 19 patients were hepatitis C virus (HCV) RNA negative and were virological complete responders to retreatment. The viral genotypes in these six patients included two each with 1b and 3a, one with 2b, and another with 2a/2b; five of the six virological responder patients had cirrhosis. Significant predictors for successful retreatment included lower baseline HCV RNA concentrations prior to the first course of therapy, 2 log10 reductions in serum HCV RNA during the initial treatment and classification into the virological 'responder/relapse' category after the first course of IFN (P < 0.01 for all observations). When the above factors were used to construct a predictive model to determine response to retreatment, it was found that the absence of a 2 log10 drop in HCV RNA concentrations during the first course of IFN therapy was the most reliable indicator of non-response to retreatment (likelihood ratio = 10, P = 0.0014). In addition, the presence of HCV RNA at week 12 of retreatment was 100% predictive of virological non-response to the 48-week course of therapy. Our findings indicate that an additional 48-week course of IFN-alpha 2b therapy at 3 MU thrice weekly will achieve a virological complete response in 60% of patients who had a 2 log10 drop in HCV RNA during their first course of treatment, and measurement of week-12 HCV RNA during retreatment to identify non-responders is beneficial to patients as well as being cost-effective. Thus, a second course of IFN remains a viable option in a subgroup of non-responder patients, regardless of genotype or the presence of compensated cirrhosis.

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Interferon for interferon nonresponding and relapsing patients with chronic hepatitis C

Myers

Poynard

2002

Cochrane Database of Systematic Reviews

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Retreatment of chronic hepatitis C virus infection

Cited by 10 publications

References 2 publications

Alpha interferon for hepatitis C virus infection in haemophilic patients

Alpha interferon for hepatitis C virus infection in haemophilic patients

Long‐term retreatment in chronic hepatitis C patients who were non‐responders to an initial course of interferon‐α2b

Interferon for interferon nonresponding and relapsing patients with chronic hepatitis C

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