Pegylated interferon alfa-2a or -2b (Pegasys and Peg-Intron, respectively) plus ribavirin is the standard treatment for patients with chronic hepatitis C. However, not all patients can be cured using this regimen, and sustained response rates are influenced by factors such as HCV genotype, disease history, stage of fibrosis, and resistance to interferon.

Consensus interferon plus ribavirin has produced better response rates than pegylated interferon plus ribavirin in some studies. The present single center study compared pegylated interferon plus ribavirin versus induction therapy with consensus interferon (Infergen) plus ribavirin in a group of treatment-naive patients with chronic hepatitis C.

Patients in the first group (n = 52) received pegylated interferon alfa-2a at the recommended dosage plus ribavirin (800-1200 mg/day); ribavirin was added in a weight-based manner for patients with HCV genotype 1 or 4, while those with genotype 2 or 3 received 800 mg/day.

Patients in the second group (n = 50) received induction therapy with high-dose consensus interferon at 18 mcg/day for 8 weeks, followed by 9 mcg/day; ribavirin was added from the beginning at 800 mg/day.

PCR was performed using the Cobas Amplicor assay. Treatment was stopped if HCV RNA was detectable at week 24. Both groups were well-matched with regard to age, sex, and HCV genotype.

Results

• Treatment was well tolerated in both treatment groups.
  
  
• However, patients in the consensus interferon group experienced significantly more side effects (e.g., fever, muscle pain, weight loss, depression, lower white blood cell count) compared to patients treated with pegylated interferon, likely due to the higher amount of daily interferon injected.
  
  
• Patients with low HCV viral load (< 800 000 IU/ml) and women in both treatment groups were more likely to achieve sustained virological response (SVR).

Conclusion

In conclusion, the study author wrote, “Treatment regimen with pegylated interferon and ribavirin is superior in regard to SVR and tolerability. Side effects are more common and severe in patients taking consensus interferon daily resulting in a higher drop out rate and lower SVR.”

The author concluded, “Consensus interferon might be favorable for difficult to treat patients with high viral load or non-response to conventional standard therapy.”

11/27/07

Reference
T Witthoeft. PEG-IFN Alfa-2A plus Ribavirin Is Superior Compared to High Dose Consensus Interferon (CIFN) and Ribavirin in the Treatment of Patients with Chronic Hepatitis C. 58th Annual Meeting of the American Association for the Study of Liver Diseases. Boston, MA, November 2-6, 2007. Abstract 337.