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Chronic hepatitis C virus patients with breakthroughs during interferon treatment can successfully be retreated with consensus interferon
Author(s) -
Heathcote E. Jenny,
James Stephen,
Mullen Kevin D.,
Hauser S. C.,
Rosenblate H.,
Albert Donald G.
Publication year - 1999
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.510300202
Subject(s) - medicine , interferon , alanine transaminase , hepatitis c virus , viremia , gastroenterology , hepatology , immunology , alpha interferon , hepatitis c , viral load , hepacivirus , antibody , virus , virology
Abstract Patients with chronic hepatitis C who have not had a sustained hepatitis C virus (HCV)‐RNA response or serum alanine transaminase (ALT) response to a 6‐month course of interferon (IFN) may respond to higher dose retreatment with consensus interferon (CIFN). Some nonresponders to initial IFN treatment have a transient response defined as undetectable HCV RNA or normalization of ALT during treatment, but subsequently have a “breakthrough” while still on treatment. The aim of this study was to determine if nonresponders who had breakthroughs responded differently to CIFN retreatment than nonresponders without breakthroughs using data from a large, multicenter trial. ALT and HCV RNA were monitored frequently during initial IFN therapy (either 9 mcg CIFN or 3 MU IFN‐α2b 3 times per week). HCV‐RNA breakthroughs were observed in 86 of 467 (18%) of all treated patients, and ALT breakthroughs were observed in 90 of 467 (19%) of all treated patients. There was no association between breakthroughs and the presence of either binding or neutralizing anti‐IFN antibodies. When the patients who were nonresponders to initial IFN treatment were retreated with CIFN (15 mcg) for 12 months, 27% of those with viral breakthroughs had a sustained viral response compared with 8% in prior nonresponders without breakthroughs (P = .102). Sustained ALT responses were observed in 39% with breakthroughs compared with 10% in those without breakthroughs (P = .014). The data suggest that prior nonresponders with breakthroughs have a greater chance of responding to retreatment than do nonresponders without breakthroughs. However, most breakthrough patients would be missed unless repeated HCV‐RNA testing were conducted during therapy.