High-Dose Interferon-α2b Plus Ribavirin for Retreatment of Interferon-Nonresponsive Patients Infected with Genotype 1 Hepatitis C Virus

Ten patients with interferon-nonresponsive chronic hepatitis C were treated with high-dose interferon-α2b (IFN-α2b; 20 MU/day for two days, then 3 MU/day for 24 weeks, followed by 3 MU three times weekly for 24 more weeks) plus ribavirin (1000–1200 mg/day). End-of-treatment virologic responses occurred in 50% of cases and sustained virologic responses in 37.5%. Hepatitis C virus RNA decreased significantly (2.15 logs; P < 0.0001) after the two 20-MU interferon doses but rebounded when the interferon dose was lowered to 3 MU/day. Thereafter, hepatitis C virus RNA showed a progressive, significant decrease, most notably at week 10 (3.3 logs; P = 0.001). Patients with a sustained response exhibited a more pronounced hepatitis C virus RNA decrease, especially from weeks 3 to 8 (P = 0.036). Two patients discontinued therapy because of adverse events, and one patient required a ribavirin dose reduction. Retreatment with an initial high-dose IFN-α2b plus ribavirin significantly reduces viral load in genotype 1-infected, interferon-nonresponsive patients.