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Effectiveness of interferon alfa‐2b/ribavirin combination therapy for chronic hepatitis C in a clinic setting
Author(s) -
Kumar* Dinesh,
WallingtonBeddoe* Craig,
George Jacob,
Lin Rita,
Samarasinghe Dev,
Liddle Chris,
Farrell Geoffrey C
Publication year - 2003
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.2003.tb05192.x
Subject(s) - ribavirin , tolerability , medicine , discontinuation , combination therapy , hepatitis c , clinical trial , adverse effect , cirrhosis , gastroenterology , alpha interferon , interferon alfa , interferon , hepatitis c virus , immunology , virus
Aim: To determine effectiveness of treatment for hepatitis C outside clinical trials, by testing the hypothesis that apparent effectiveness and tolerability of interferon alfa‐2b/ribavirin combination therapy would be less in a hospital liver clinic setting. Design: Retrospective analysis of all patients in one centre commencing interferon alfa‐2b/ribavirin therapy, but not in clinical trials, between 1998 and 2000. Main outcome measures: Effectiveness as sustained virological response (SVR); tolerability as premature discontinuation of treatment. Results: The 121 patients had similar demographic and viral characteristics as those in Australian trials (age, 44 ± 10 years; males, 66%; genotype 1, 44%; genotype 3, 36%), but 38% had advanced fibrosis, including 17% with cirrhosis. Sixty (50%) were previously untreated, 38 (31%) had relapsed after initial response (response relapse) and 23 (19%) were non‐responders to interferon monotherapy. Sustained viral response (SVR) was achieved in 53% of patients overall: 47% of patients with genotype 1 HCV, 71% of patients with genotype 3. For patients with genotype 1 HCV, SVR was 43% in those previously untreated, 63% in response relapsers, and 38% in non‐responders. Corresponding SVRs for genotype 3 were 65%, 87% and 33%. These results are similar to those obtained in published trials. Only 7% of our patients discontinued treatment because of adverse effects, fewer than reported in most clinical trials. Dose reduction was required in 18% of patients. Conclusions: In a hospital clinic setting the effectiveness of interferon alfa‐2b/ribavirin combination therapy appears equivalent to published results from clinical trials.