Daily Dosing of 5 MIU Interferon with Ribivarin Eliminates HCV-RNA After day 28

Commentary: To me, the preliminary data from this study underscore data from other studies suggesting that the standard dose of 3 MIU three times per
week is inadequate. Daily dosing of interferon provides more promise for achieving a sustained virological response.

At a liver meeting in Europe (EASL - European Assn for the Study of Liver Disease) this past Spring, researchers for the Swiss Association for the Study of the Liver reported preliminary data on daily dosing of interferon with ribivarin for individuals who were previously non-responders to interferon. In a single-arm open label study 55 patients received interferon-a2b 5 MIU subcutaneous every day wth ribivarin (1000 mg if <75 kg body weight, ig >75 kg 1200 mg. They received therapy for 28 days when an initial assessment was made of HCV-RNa and quality of life.

28 patients (67%) had genotype 1b and 34 (62%) had had baseline HCV-RNA >3 million copies/ml.

Results:

**37 patients (67%) had lost serum HCV-RNA by day 28

**(29/44, 66% men), (8/11 73% women);

**22/37 60% >40 yrs age; 15/18 (83%) <40 yrs age;

**31/46 67% cirrhotics;

**18/28 64% genotype 1b; 19/27 70% genotype non-1b;

**15/21 71% with baseline HCV-RNA >3 million copies/ml; 22/34 65% with baseline HCV-RNA <3 million copies/ml.

Most responders normalized their liver enzymes.

No patient had to discontinue due to side effects.

Quality of life decreased from median 8.3 (range 3.0-10.0) prior to therapy to 6.4 (2.5-10.0).

30/55 55% of patients missed at least one working day, and 6/65 11% missed 5 or more.

Conclusion:
The study authors said daily interferon dosing with ribivarin leads within 28 days to a virological response in 2/3 of previous interferon non-responders and is acceptably tolerated. The long term efficacy of this regimen which in responders is followed by a 12 month standard dose of interferon+ribivarin remains to be seen.