Different doses of consensus interferon plus ribavirin in patients with hepatitis C virus genotype 1 relapsed after interferon monotherapy: a randomized controlled trial

AIM: To assess the efficacy of different schedules of consensus interferon (CIFN) plus ribavirin in retreatingchronic hepatitis C patients who relapsed after recombinant interferon (rIFN) monotherapy.METHODS: Forty-five patients (34 males and 11 females) with chronic hepatitis due to hepatitis C virus(HCV) genotype 1 who relapsed after a previous course of rIFN monotherapy were randomized to receive 9 μgCIFN three times per week for 52 wk (group A, n = 22) or 18 μg CIFN three times per week for 52 wk (groupB, n = 23) in combination with ribavirin 800 to 1200 mg daily for 52 wk (according to body weight). Virologicalresponse was evaluated at week 24 (EVR), at the end of treatment (ETR) and at 76 wk (SVR).RESULTS: By intention-to-treat analysis, subjects in group A had an EVR in 35% of cases, an ETR in 35%and a SVR in 27.3% of cases. Subjects in group B had an EVR in 32% of cases, an ETR in 35% and a SVR in26.1% of cases. Treatment was stopped because of adverse effects (mostly intolerance) in 15 patients (6in group A and 9 in group B). IFN dose reduction was needed in 2 patients (1 in group A and 1 in group B).Ribavirin dose was reduced in 2 patients in group A and 1 in group B respectively. Among the 15 subjects whoreceived at least 80% of the intended schedule, the rate of SVR was 80% (6 in group A and 6 in group B).CONCLUSION: CIFN in combination with ribavirin when given to HCV genotype 1 relapsers after rIFNmonotherapy obtains an unsatisfactory rate of sustained viral clearance independently of dosage of the drug. This may be due to its scarce tolerability.