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Combination therapy for the treatment of hepatitis C in the veteran population: higher than expected rates of therapy discontinuation
Author(s) -
Getachew Y.,
Browning J. D.,
Prebis M.,
Rogers T.,
Brown G. R.
Publication year - 2004
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2004.02095.x
Subject(s) - medicine , discontinuation , ribavirin , cirrhosis , gastroenterology , population , hepatitis c , randomized controlled trial , hepatitis c virus , combination therapy , immunology , virus , environmental health
Summary Aim : To compare the efficacy of high‐dose induction with standard dose interferon therapy for the treatment of chronic hepatitis C virus at the Dallas Veterans Affairs Medical Center. Methods : Patients were randomized to receive 5 million units daily interferon‐ α 2b for 4‐weeks followed by 44‐weeks for genotype 1 or 20 weeks for non‐genotype 1 of standard dose therapy (3 million units three times a week) or standard dose therapy for total treatment duration. Daily weight‐based ribavirin was used for entire therapy interval. Results : Forty‐five patients were enrolled in the trial with genotype 1 comprising 75.6% of the sample. Cirrhosis or bridging‐fibrosis was present in 69% of the patients. Of the 29 liver biopsies available for Knodell scoring, 41% and 51% had scores of 6–10 and 11–15, respectively. Rates of sustained virological response did not differ significantly between the two treatment groups. Therapy type and/or early intervention for depression did not affect the rate of therapy discontinuation, which was 26.6%. Conclusion : The rate of sustained virological response was similar between the two treatment groups and higher than anticipated among patients with cirrhosis or bridging‐fibrosis. The rate of therapy discontinuation was also higher than anticipated but was not attributable to therapy type or untreated depression.