Effect of pegylated interferon

Objectives: To assess whether a combination of pegylated interferon (interferon conjugated with polyethylene glycol) and ribavirin can improve the response rate in patients with chronic hepatitis C who either did not respond to (Non-responders), or had relapsed after responding to (Relapsers) standard interferon and ribavirin combination therapy. Patients and methods: In this prospective study, 20 chronic hepatitis C patients (comprising 16 Non-responders and 4 Relapsers to previous treatment with alpha interferon and ribavirin), were treated with pegylated interferon-2b weekly and ribavirin daily for one year. Eleven patients had genotype 4, eight were of genotype 1 and one patient had genotype 3. Response to treatment was determined based on normalisation of liver enzymes and negative viral load (assessed using qualitative HCV RNA PCR) at end of treatment (ETR) and 6 months off treatment (SVR). Results: Seven patients (35%) achieved normalisation of liver enzymes and negative viral load at the end of treatment. However, only 2 patients (10%) managed to retain these levels after six months off treatment. The latter two patients had been previous Relapsers. Conclusion: Combination of pegylated interferon and ribavirin may be beneficial in previous relapsers with standard interferon-ribavirin combination therapy, but is unlikely to achieve sustained virological response in non-responders.