The "Hit Hard And Hit Earl" Strategy To Treat Chronic Hepatitis C

Daily dosed interferon-alpha may prevent mutations of the hepatitis C virus (HCV) quasi-species and may therefore be more efficient in the treatment of chronic hepatitis C than the conventional therapy regimen given three times a week (1,2). The drop of viral load in the initial therapy phase has been shown to substantially influence the sustained response rates (3,4). In this randomised case controlled study seventy therapy-naive patients with chronic hepatitis C were analysed before, during and after IFN treatment. Group A comprised 42 patients, 24 with genotypes 1 or 4 and 18 with genotypes 2 or 3, that received an induction monotherapy with 6 MIU interferon alfa-2a daily s.c. for 12 weeks. After interferon dosages were tapered down to 4.5 MIU and 3 MIU daily for 4 weeks each, HCV-RNA negative patients received maintenance therapy containing 3 MIU interferon alfa-2a three times weekly plus 800 mg ribavirin p.o. daily for another seven months. Group B comprised 28 patients, 22 with genotype 1 and 6 with genotypes 2 or 3, that had been treated with 6 miu interferon alfa-2a three times weekly for 12 weeks. Then, patients with negative HCV-RNA received the same maintenance combination therapy as described above. Informed written consent was obtained from each subject before treatment. Furthermore, the study protocol was been approved by the local ethics committee.