RESUMEN
Interferon alfa is the only effective treatment for chronic hepatitis C. Forty percent of patients have an initial response to this therapy but most subsequently relapse. The effect of interferon alone was compared with that of interferon plus oral ribavirin for the treatment of chronic hepatitis C genotype N. A total of 47 patients with chronic hepatitis C doses were assigned to receive standard doses of recombinant interferon alfa - 2b and 45 patients were assigned to receive interferon alpa-26 with ribavirin [1000 to 1200 mg orally per day, depending on body weight] for six months. At the completion of treatment, HCV-RNA was undetected in d 9 of the 45 patients who were treated with interferon and ribavirin and in 11 of the 47 patients who were treated with interferon alone [42.2% As compared with. 23.4%, p<0.0751. Serum HCV-RNA remained undetected 24 weeks after the end of treatment in 12 patients [26.65%] in the combination therapy group, but only 3 patients [6.3%] in the interferon group [p>0.010].Sustained normalization of serum alanine aminotransferase [ALT] and histologic improvement were highly correlated with virologic response. Combined therapy caused a predictable fall in hemoglobin concentrations but otherwise had a safety profile similar to that of interferon alone. In conclusion, in patients with chronic hepatitis C genotype W therapy with interferon and oral ribavirin resulted in higher rates of sustained virologic, biochemical response than treatment with interferon alone
RESUMEN
Ribavirin is a nucleosi.de analogue with a broad spectrum of antiviral action. 17 patients with chronic hepatitis C were treated with oral ribavirin at a dose of 15 mg/Kg per day for 6 months. S e m alanine aminotransferase [ALT] activities decreased significantly [P<0.005] during ribavirin treatment [mean ALT before treatment was 117.01 +/- 50.3 1 U/ ml and 65.01 +/- 31.09 U/ml by the end of treatment]. ALT levels became normal in 5 cases [29.5%], significantly decreased in 8 cases [47%], but did not significantly change in the remaining 4 cases [23.5%]. Serum ALT in all the responding patients returned to pretreatment levels 2 months after stopping the treatment. Before treatment, serum hepatitis C virus [HCVRNA was detected by polymerase chain reaction [PCR] in all 17 patients. At the end of treatment, 5 of these 17 patients had become negative for HCV - RNA but they became positive again 3 months after discontinuation of treatment. The response to ribavirin was not correlated with HCV genotypes and liver histopathology in all patients and there was no significant difference between responders and non-responders. Ribavirin treatment resulted in mild, reversible hemolysis and none of the patients exhibited symptomatic anemia. These findings suggest that ribavirin has a beneficia1 effect on patients with chronic hepatitis C, although further studies are needed to determine how ribavirin can be best used