Sustained response to INF rarely achieved with high viral load


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Dig Dis Sci 2000 Mar;45(3):565-74
Sustained viral response is rarely achieved in patients with high viral load of HCV RNA by excessive interferon therapy.
Shiratori Y, Kato N, Yoshida H, Nakata R, Ihori M, Imazeki F, Yokosuka O, Kawase T, Katamoto T, Unuma T, Nakamura A, Ikegami F, Hirota K, Omata M Department of Internal Medicine (Gastroenterology), University of Tokyo, Japan.

Adequate dosing of interferon (IFN) and its cost-effectiveness for sustained virological response were evaluated in relation to viral load and subtype.

Prospective analysis of IFN therapy on 326 patients with chronic hepatitis C free from cirrhosis was performed using 9 or 6 million unit (MU) of IFN for six months daily and/or three times a week.

Sustained virological response was achieved in 50-94% of patients with less than or = 2 x 10(4) copies/ml (competitive RT-PCR) or less than 100 x 10(3) copies/ml (Amplicor monitor) of HCV RNA by 468-1206 MU of IFN, but response was only 0-25% of the patients with > or = 2 x 10(5.5) copies/ml (competitive RT-PCR) or greater than 200 x 10(3) copies/ml (Amplicor monitor), even with 468-1206 MU of IFN.

A high sustained rate was demonstrated in patients with 100-200 x 10(3) copies/ml of HCV RNA by 901-1206 MU of IFN, in comparison to that with less than or = 900 MU of IFN.

Multivariate analysis showed that IFN dose had a significant value for the efficacy of IFN therapy in patients presenting 100-200 x 10(3) copies/ml of HCV RNA.

Cost efficacy analysis indicated that it cost approximately $10,000, $26,000, and $50,000-227,000 for one person-viral eradication in the patients with less than 100, 100-200, and greater than 200 x 10(3) copies/ml, respectively.

High-dose IFN is only cost effective in patients with intermediate viral loads, and IFN therapy could be recommended in patients with less than 200 x 10(3) copies/ml of HCV RNA.

PMID: 10749334, UI: 20210905

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