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Interferon Treatment of HCV with Cirrhosis
Among patients with hepatitis C who have cirrhosis the rate of
sustained response following interferon therapy is only half that
of patients without cirrhosis. Although it has been suggested that
a higher dose regime in patients with cirrhosis may improve
response, this remains largely untested. The results of a recent
Australian study of cirrhotic patients who were given an intense
interferon programme of 4.5 MIU daily for 24 weeks were compared
with previous studies of patients with hepatitis C. Of 11 studies
of interferon response in chronic hepatitis C comparison of
pretreatment variables showed considerable differences.
Identification of predictors of response by univariate and
multivariate analysis regularly indicated the importance of age and
fibrosis, Analysis of six studies with either a poor (5% or less)
or a reasonable (14-19%) sustained response rate to interferon in
patients with cirrhosis suggested that a higher dose or longer
duration of therapy was associated with better results, The
experience of the Australian study, where 14% of patients had a
sustained biochemical response to interferon and side -effects were
reasonably tolerated with careful monitoring, suggests that future
studies in cirrhosis should be carried out exploring higher doses
and longer durations of therapy.
Author: COOKSLEY WGE, ROYAL BRISBANE HOSP FDN, CLIN RES CTR,
BRISBANE QLD 4029 Source: JOURNAL OF VIRAL HEPATITIS 1997
;4:85-88
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