Continuous versus intermittent therapy for chronic hepatitis C with recombinant interferon alfa-2a

• Published in: Gastroenterology (New York, N.Y. 1943) Vol. 107; no. 2; p. 479
• Main Authors: Negro, F, Baldi, M, Mondardini, A, Leandro, G, Chaneac, M, Manzini, P, Abate, M L, Zahm, F, Dastoli, G, Ballaré, M
• Format: Journal Article
• Language: English
• Published: United States 01.08.1994
• Subjects: Adolescent; Adult; Aged; Antibodies - metabolism; Chronic Disease; Drug Administration Schedule; Female; Follow-Up Studies; Hepacivirus - genetics; Hepatitis C - immunology; Hepatitis C - microbiology; Hepatitis C - therapy; Humans; Interferon alpha-2; Interferon-alpha - administration & dosage; Interferon-alpha - immunology; Interferon-alpha - therapeutic use; Male; Middle Aged; Recombinant Proteins; RNA, Viral - analysis
• ISSN: 0016-5085; 1528-0012
• DOI: 10.1016/0016-5085(94)90174-0

Prolonged interferon administration to patients with chronic hepatitis C, although increasing the sustained response rate, is poorly accepted and may favor drug resistance. A pulse-treatment schedule would be preferred for compliance and costs. One hundred thirty-five patients with chronic hepatitis C received 6 MU units of interferon alfa-2a, three times weekly, continuously for 9 months (group 1: 66 patients) or for two 3-month cycles, separated by 6 months pause (group 2: 69 patients). At the end of therapy, 25 of 54 patients of group 1 (46.3%) and 28 of 60 of group 2 (46.7%) had normal serum aminotransferase levels. Six months after the end of treatment, sustained responders were still similar in the two groups (11 or 16.7% vs. 7 or 10.1%; NS). A loss of response before the end of therapy was seen in 10 patients of group 1 and 6 of group 2; interferon-neutralizing antibodies developed in 1 of 7 and 6 of 6 of such patients, respectively. The intermittent administration of interferon alfa-2a to patients with chronic hepatitis C shows a sustained response rate comparable with that achieved with continuous treatment at the same dosage. Hepatitis breakthroughs during pulse therapy appeared to be limited to interferon neutralizing antibodies, whereas a prolonged, continuous treatment is more likely to induce other forms of interferon resistance.