Effect of induction therapy on Hepatitis C

OBJECTIVE: To assess the response to one month induction combination therapy using alpha interferon and Ribavirin on patients with chronic hepatitis C.

METHODS: Eighty patients with naive compensated chronic hepatitis C (group A) were followed at King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia from October 1996 through February 2000 received daily subcutaneous injection of alpha interferon -2b (Intron A 3 million units) plus Ribavirin 1-1.2 grams (induction) for one month followed by Intron A, 3 times a week together with daily Ribavirin (same dose) for 11 months. Response, assessed based on viral load and liver enzymes, was compared to that of 27 patients (group B) who received Intron A 3 million units 3 times weekly and daily Ribavirin (same dose) for 12 months (standard regimen).

RESULTS: A total of 39 patients in group A (48.7%) and 11 patients in-group B (40.7%) had end of treatment response. Twenty nine patients in group A (36.2%) and 5 patients in group B (18.5%) had sustained virologic response. Thirty-seven patients in group A (46.2%) and 6 patients in-group B (22.2%) had sustained biochemical response. None of the patients with cirrhosis in both groups had sustained virologic response. In addition, sustained virologic response in patients with genotype-one and 4 was 31.4% (22 out of 70 patients) in group A and 15.3% (4 out of 26 patients) in group B.

CONCLUSION: Induction combination therapy improves the sustained biochemical and virologic responses most likely by early prevention of mutation of the virus, which in turn plays a role in the relapse rate.