Hepatitis C patients who have unsuccessfully undergone treatment with the combined therapy of interferon plus ribavirin may respond to treatment with ribavirin alone, according to a study reported in the July issue of Hepatology.
About half of hepatitis C patients fail to have a sustained virologic response to to combination interferon and ribavirin therapy. For this group, the further treatment options are limited.
The study involved 34 patients who were still hepatitis C virus RNA positive after being treated with a combination of interferon alfa and ribavirin for 24 weeks. The patients were split into two groups, either receiving ribavirin alone or a placebo.
Researchers regularly monitored the patients symptoms, serum aminotransferase levels, hepatitis C virus RNA levels and complete blood counts. The participants also underwent liver biopsy at the completion of therapy.
Among the 17 patients who received a placebo, no overall improvement in symptoms, serum alanine aminotransferase (ALT) levels, hepatitis C virus RNA levels or hepatic histology were detected.
The 17 patients who received ribavirin experienced improved serum ALT levels, but their hepatitis C virus RNA levels and hepatic fibrosis scores were not changed significantly from baseline.
"Continuation of ribavirin monotherapy may maintain serum biochemical improvements that occur during interferon-ribavirin combination therapy in some patients," concluded the researchers. "Whether these improvements will ultimately result in prevention of progression of hepatitis C requires further study."
Other sources: Hepatology 2003;38:66-74