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Daily dose of interferon alpha-2b and ribavirin in treatment-naive patients with chronic hepatitis C virus genotype 1 infection: a randomised controlled study

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The treatment of patients with hepatitis C virus (HCV) genotype 1 infection remains disappointing.


In 1999, we started a multicentre study comparing two regimens of recombinant interferon (IFN) alpha-2b plus ribavirin. Group A (90 patients) received ribavirin plus IFN alpha-2b 5 MU/day for 1 month (induction therapy) followed by IFN alpha-2b 5 MU thrice weekly for 5 months. Group B (85 patients) received ribavirin plus IFN alpha-2b 5 MU thrice weekly for 6 months. Responders in both arms received IFN alpha-2b 3 MU thrice weekly for a further 6 months. A followup evaluation was performed at 18 months.


One hundred and seventy-five consecutive treatment-naive patients with HCV genotype 1 infection were enrolled in the study. A sustained virological response (SVR) was obtained in 51 (29%) patients: 28 in group A (31%) and 23 in group B (27%). HCV-RNA clearance was greater at 3 months among patients who received induction therapy (57 vs 39%; p <0.02). Age, sex, and initial viral load did not influence the achievement of a SVR. HCV clearance at the end of the study was lower in cirrhotic patients (3/26 vs 48/149; p<0.05). The only SVR in patients with cirrhosis occurred in those from group A (p<0.05). Both regimens were well tolerated.


This study confirms the low rate of SVR in treatment-naive patients with HCV genotype 1 infection treated with IFN alpha-2b plus ribavirin. A 4-week induction regimen was slightly superior to standard IFN alpha-2b plus ribavirin. Although the number of patients with cirrhosis was low, induction therapy seemed to be more effective in cirrhotics. Given its safety and tolerability, the induction regimen evaluated here may be a therapeutic option in treatment-naive patients with HCV genotype 1 infection

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  1. 1.

    National Institutes of Health Consensus Development Conference Panel statement: management of hepatitis C.Hepatology 1997; 26 (Suppl 1): 2S–10S.

  2. 2.

    Davis GL. Monitoring of viral levels during therapy of hepatitis C.Hepatology 2002; 36 (Suppl 1): S145-S151.

  3. 3.

    Cawthorne CH, Rudat KR, Burton MS, et al. Limited success of HCV antiviral therapy in United States veterans.Am J Gastroenterol 2002; 97:149–55.

  4. 4.

    Falck-Ytter Y, Kale H, Mullen KD, Sarbah SA, Sorescu L, McCullough AJ. Surprisingly small effect of antiviral treatment in patients with hepatitis C.Ann Intern Med 2002; 136:288–92.

  5. 5.

    Zeuzem S, Lee JH, Franke A, et al. Quantification of the initial decline of serum hepatitis C virus RNA and response to interferon alfa.Hepatology 1998;27:1149–56.

  6. 6.

    Carithers RL, Zeuzem S, Manns MP, et al. Multicenter, randomized, controlled trial comparing high dose daily induction interferon plus ribavirin versus standard interferon alfa-2b plus ribavirin [abstract].Hepatology 2000;32 (Suppl): 317A.

  7. 7.

    Bekkering FC, Stalgis C, McHutchison JG, Brouwer JT, Perelson AS. Estimation of early hepatitis C viral clearance in patients receiving daily interferon and ribavirin therapy using a mathematical model.Hepatology 2001;33:419–23.

  8. 8.

    Zeuzem S, Herrmann E, Lee JH, et al. Viral kinetics in patients with chronic hepatitis C treated with standard or peginterferon alfa-2a.Gastroenterology 2001;120:1438–47.

  9. 9.

    Hadziyannis AS, Papaioannou C, Spanou F, Manesis EK, Hadziyannis SJ. Induction interferon therapy in naive patients with chronic hepatitis C: increased end-of-treatment virological responses but absence of long-term benefit.Aliment Pharmacol Ther 2001;15:551–7.

  10. 10.

    Ferenci P, Brunner H, Nachbaur K, et al. Combination of interferon induction therapy and ribavirin in chronic hepatitis C.Hepatology 2001;34:1006–11.

  11. 11.

    McHutchison JG, Manns M, Patel K, et al. Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C.Gastroenterology 2002;123:1061–9.

  12. 12.

    Di Bisceglie AM, Hoofnagle JH. Optimal therapy of hepatitis C.Hepatology 2002;36 (Suppl 1):S121-S127.

  13. 13.

    Poynard T, Leroy V, Cohard M, et al. Meta-analysis of interferon randomized trials in the treatment of viral hepatitis C: effects of dose and duration.Hepatology 1996;24:778–89.

  14. 14.

    Manns MP, McHutchison JG, Gordon SC, et al. Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial.Lancet 2001;358:958–65.

  15. 15.

    Hadziyannis SJ, Cheinquer H, Morgan T, et al. Peginterferon alfa-2a (40 kD) (Pegasys) in combination with ribavirin (RBV): efficacy and safety results from a phase III, randomized, double-blind, multicentre study examining effect of duration of treatment and RBV dose [abstract].J Hepatol 2002;36 (Suppl 1):3.

  16. 16.

    Fried MW, Shiffman ML, Reddy KR, et al. Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection.N Engl J Med 2002;347:975–82.

  17. 17.

    McHutchison JG, Gordon SC, Schiff ER, et al. Interferon alfa-2b alone or in combination with ribavirin as initial treatment for chronic hepatitis C. Hepatitis Interventional Therapy Group.N Engl J Med 1998;339:1485–92.

  18. 18.

    Poynard T, Marcellin P, Lee SS, et al. Randomised trial of interferon alfa-2b plus ribavirin for 48 weeks or for 24 weeks versus interferon alfa-2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus. International Hepatitis Interventional Therapy Group (IHIT).Lancet 1998;352:1426–32.

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Correspondence to GianPiero Benetti.

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Benetti, G., Borzio, M., Ramella, G. et al. Daily dose of interferon alpha-2b and ribavirin in treatment-naive patients with chronic hepatitis C virus genotype 1 infection: a randomised controlled study. Int Emergency Med 1, 113–118 (2006). https://doi.org/10.1007/BF02936535

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Key words

  • chronic hepatitis C
  • cirrhosis
  • genotype 1
  • induction therapy