02 Aug

High dose consensus interferon in nonresponders to interferon alpha-2b and ribavirin with chronic hepatitis C: DISCUSSION (Part 1)

patient population of nonresponders

As expected, our patient population of nonresponders to IFN alpha-2b and ribavirin had characteristics typical of those with a poor response to antiviral therapy (ie, genotypes 1 and 4, cirrhosis on liver biopsy and male sex). The present study indicates that some patients with hepatitis C infection, although resistant to full doses of standard IFN alpha-2b plus ribavirin, may respond to high dose CIFN monotherapy.

Earlier studies have shown that patients who failed six months of standard IFN alpha-2b or CIFN monotherapy could achieve a sustained virological response when retreated with CIFN, three times a week, for 12 months rather than six months, with a sustained virological response rate of 13% in previous nonresponders.

Few studies have reported the efficacy of retreatment of nonresponders to previous full dose combination therapy with IFN alpha and ribavirin, and none have employed high dose standard IFN monotherapy in this situation. One study added the antiviral amantadine to retreatment with IFN alpha-2b and ribavirin in previous nonresponders to IFN alpha-2b and ribavirin and achieved a strikingly high (57%) sustained virological response rate. Other studies with modified protocols unfortunately have not been able to repeat these excellent results. The addition of other nonantiviral agents (eg, ursodeoxycholic acid) yields a higher biochemical but not an enhanced virological response. An alternative approach is not to attempt virological cure, but rather to minimize the long term effect of inflammation caused by the virus (ie, fibrosis). This was achieved in a short course (90 days) of interleukin-10, but no long term studies using this agent have been reported. If you want to make your online shopping advantageous and safe, check out the best pharmacy to buy levitra professional sale without any need for a prescription, any time of the day or night with straight to the doorstep delivery.

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