03 Aug

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

The high dose therapy with CIFN, given during the initial 12-week induction phase in the present study, had a high side effect profile. The symptoms precipitating withdrawal from CIFN therapy in the present group of highly motivated patients were systemic, namely weakness, irritability and, in one patient, profound confusion. These side effects were maximal during the first three months during the ‘induction’ period and disappeared in all patients within one week of treatment cessation. Although dosing was daily, the short half-life of standard IFN causes wide fluctuations in serum IFN levels; the sudden troughs in serum concentrations of IFN are likely responsible for the severe ‘flu-like symptoms . These symptoms may be less with the more constant serum IFN levels provided by pegylation. Of the six patients who withdrew before receiving three months of treatment, all six (100%) had documented cirrhosis. In patients with hepatitis B virus treated with IFN, more psychiatric side effects have been observed in patients with cirrhosis.

In the present study, one-half of patients who had undetectable HCV RNA after induction therapy had a virological breakthrough as soon as CIFN, three times weekly, was administered after week 12. If viral replication had been continually suppressed for longer, it is conceivable that a greater sustained virological response could have been achieved. Because of the high side effect profile of high dose CIFN, this was unfeasable. The addition of oral ribavirin to INF therapy markedly reduces the relapse rate and, thus, enhances the antiviral response to IFN drug therapy.

The present pilot study shows that in a population of nonresponders to full-dose IFN alpha-2b plus ribavirin, loss of detectable virus with high dose daily CIFN is possible in one-half of patients. Thus, it is postulated that if high serum concentrations of IFN can be maintained with fewer side effects, as is possible with pegylated IFN, it may be reasonable to use this modified IFN to retreat nonresponders to standard IFN alpha-2b and ribavirin. You are always offered finest quality levitra professional sale at the pharmacy you can fully trust and enjoy being its customer. Why wouldn’t you, if it offers lowest prices in the industry and fast delivery that can be free for some orders?

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