Interferon-α-2b and ribavirin for retreatment of chronic hepatitis C

Background/Aims: Subjects with chronic hepatitis C who fail treatment with interferon-alpha are generally divided into two groups: "relapsers" who normalized serum aminotransferase activity and have undetectable viral RNA during treatment and "nonresponders" who do not achieve these results. The aim of this study was to examine retreatment of such subjects. Methodology: We studied 117 subjects with chronic hepatitis C who failed treatment with interferon-a, 87 of whom were "non-responders" and 30 "relapsers." Retreatment was with either interferon-alpha-2b plus ribavirin for 48 weeks or with interferon-alpha-2b plus placebo for 24 weeks followed by 24 weeks of combined therapy. Results: Sustained response rates, defined as undetectable viral RNA in serum 6 months after retreatment, were 53% in "relapsers" and 10% in "nonresponders" (P<0.005). There was no significant difference if ribavirin was given for 24 or 48 weeks. In "non-responders" infected with genotypes other than type 1, 42% achieved a sustained response compared to 5% infected with genotype 1 (P=0.027; odds ratio 7.09). Conclusions: Treatment with interferon-a-2b plus ribavirin is effective in approximately 50% of "relapsers" and "non-responders" infected with nontype I genotypes of hepatitis C virus. This therapy is only marginally effective in "non-responders" infected with genotype la or 1b.