ABSTRACT
The aim of four-year follow up study was evaluation of re-treatment efficacy of antiviral therapy in patients with hepatitis C who failed to respond (non responders) to previous therapy. Study enrolled 29 patients, aged 21-59 with HCV infection (15 had HCV genotype 1, and 14 had HCV non-genotype1), who previously were treated with unmodified interferon alfa (conventional interferon) 2a or 2b 5 MIU TIW plus ribavirin (1000-1200 mg/day) and who failed under this therapy. Study subjects were randomized into two groups: in group I were included 17 patients--relapsers (patient in whom HCV RNA becomes undetectable on treatment and is undetectable at the end of therapy, but is detected again after discontinuation of treatment). Group II was composed of 12 patients: 4 were non responders (patient in whom HCV RNA levels remain stable on treatment), 4--partial responders (HCV RNA levels decline by >2 logs, but never become undetectable during treatment) and 4--breakthrough non responders (HCV RNA become undetectable during treatment, but before-treatment termination again become detectable). The diagnosis of HCV infection was made based on detection of HCV antibodies by ELISA and confirmed by RIBA. Detection of HCV RNA (qualitative) and HCV RNA Viral load--by Real time PCR technique (COBAS TaqMan Test). HCV genotypes were detected by INNO-Lipa method. In group I--rapid virological response (RVR) was observed in 10 (58%) patients, early viral response (EVR) in 12 patients (70%). Among them 9 (52%) patients remained HCV RNA undetectable by the end of treatment. After 6 months sustained viral response (SVR) was received in 7 (41%) patients from group I. In group II--RVR was observed in 5 (41%), EVR in 6 (50%) patients. Among them 5 (41%) patients remained HCV RNA undetectable by the end of treatment. After 6 months Sustained Viral Response was received in 3 (25%) patients. Re-treatment with pegylated interferon and ribavirin in patients with hepatitis C who failed to responds to previous treatment was effective in relapsers. Re-treatment in non responders, partial responders and breakthrough non responders was less effective (especially in non responders). Re-treatment effectiveness was higher in HCV genotype non 1 patients in comparison with HCV genotype 1. Thus re-treatment will be considered for relapsers. For making decision on re-treatment for other nonresponders, severity of disease (advance disease) should be considered.
Subject(s)
Antiviral Agents/administration & dosage , Hepatitis C/drug therapy , Interferon-alpha/administration & dosage , Polyethylene Glycols/administration & dosage , Ribavirin/administration & dosage , Adult , Dose-Response Relationship, Drug , Drug Carriers , Drug Therapy, Combination , Enzyme-Linked Immunosorbent Assay , Female , Follow-Up Studies , Hepacivirus/genetics , Hepacivirus/immunology , Hepatitis C/diagnosis , Hepatitis C/virology , Hepatitis C Antibodies/analysis , Humans , Interferon alpha-2 , Male , Middle Aged , Polymerase Chain Reaction , RNA, Viral/analysis , Recombinant Proteins , Retreatment , Treatment Outcome , Viral Load , Young AdultABSTRACT
A study was made of the therapeutic efficacy of human leukocytic interferon (HLI) and leikinferon in the treatment of HBV- and HDV-infection. 21 patients were placed under observation. Of these, 6 presented with lingering hepatitis B (HB), 8 with chronic HB, 1 was a HBsAg carrier, 4 had Grades I-IV, acute hepatic encephalopathy, and 2 acute hepatitis delta. 15 patients received leikinferon, 6 were given HLI for injections. Indications and schemes for the treatment with interferon preparations are provided as are the clinico-biochemical and serological criteria for estimating the efficacy of interferon therapy. In lingering and chronic forms of HB, leikinferon exerts a beneficial effect. It is not costly, thus enabling one to carry out continuous treatment in patients suffering from chronic forms. HLI may be recommended as an effective agent.
Subject(s)
Cytokines/therapeutic use , Hepatitis B/therapy , Hepatitis D/therapy , Interferon Type I/therapeutic use , Interferon-alpha/therapeutic use , Adolescent , Adult , Aged , Child , Child, Preschool , Cytokines/administration & dosage , Cytokines/adverse effects , Drug Combinations , Drug Evaluation , Female , Hepatitis B/immunology , Hepatitis D/immunology , Humans , Injections, Intramuscular , Interferon Type I/administration & dosage , Interferon Type I/adverse effects , Interferon-alpha/administration & dosage , Interferon-alpha/adverse effects , Male , Middle Aged , Remission Induction , Time FactorsSubject(s)
Cytokines , Hepatitis B/therapy , Interferon Type I/therapeutic use , Adult , Alanine Transaminase/blood , Bilirubin/blood , Drug Combinations/administration & dosage , Drug Combinations/adverse effects , Drug Combinations/therapeutic use , Drug Evaluation , Hepatitis B/blood , Hepatitis B/immunology , Hepatitis B Antibodies/analysis , Hepatitis B Surface Antigens/analysis , Hepatitis B e Antigens/analysis , Humans , Interferon Type I/administration & dosage , Interferon Type I/adverse effects , Remission Induction , Time FactorsABSTRACT
The therapeutic efficacy of human leucocytic alpha-interferon and combiferon produced in the N.F. Gamaleya Institute of Epidemiology and Microbiology, was assessed in 27 patients with different types of hepatitis B and in 30 controls. A marked clinical effect was noted in therapy of acute types of hepatitis B: the improvement of clinical and immunological indices, the reduction of the duration of HBs-antigenemia. The treatment of chronic types was effective in 5 out of 8 patients. A therapeutic scheme for acute and chronic types of hepatitis B was given.
