Forum (Genova) 2000 Jan-Mar;10(1):63-9
Buti M, Esteban R; University General Hospital Valle de Hebron,
An important group of patients with chronic hepatitis C do not
respond to interferon (IFN) therapy.
Compared with untreated patients with chronic hepatitis C,
non-responders have a higher percentage of cirrhosis, are more
frequently infected by genotype 1 and usually have a viral load
above 2 x 106 copies/ml.
Also, patients with cirrhosis have lower life expectancy and
higher risk of clinical complications, and therefore, are most in
need of effective treatment strategies.
There is no evidence that the re-treatment of non-responders
with a standard regimen of IFN or more prolonged IFN therapy
achieves a sustained biochemical or virological response.
Between 20% and 40% of non-responder patients treated with IFN
therapy for more than two years had an hepatic improvement in liver
histology associated with a decrease in hepatitis C
virus-ribonucleic acid levels.
In contrast, combination therapy with IFN and ribavirin for six
months now results in sustained response rates between 6% and 29%
depending on the viral genotype and the presence or absence of
Patients infected with genotype 2 and 3 have a higher
probability of achieving a sustained virological response than
those infected by genotype 1.
Currently, different studies are underway to determine whether
high-dose IFN and/or induction therapy combined with ribavirin for
more prolonged periods of time could increase the sustained
response rate in non-responders.
No other drugs appear to be efficacious in these patients,
except the combination of IFN, ribavirin and amantadine which has
shown interesting results in a preliminary trial but they need to
be confirmed in further studies.
These findings suggest that combination therapy is beneficial
and can be recommended for some non-responder patients until other
new therapies are available.
Publication Types: Review, tutorial; PMID: 10717258, UI:
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