Efficacy of Combination of Interferon α 2a , Ribavirin and UDCA in the Treatment of Chronic Hepatitis C

Korean J Hepatol > Volume 4(2); 1998 > Article

The Korean Journal of Hepatology 1998;4(2): 109-119.

원저 : 만성 C형 간염 환자에서 인터페론 α 2a , 리바비린 및 UDCA 병합요법의 효과 ( Original Articles : Efficacy of Combination of Interferon α 2a , Ribavirin and UDCA in the Treatment of Chronic Hepatitis C )

Efficacy of Combination of Interferon α 2a , Ribavirin and UDCA in the Treatment of Chronic Hepatitis C

Dong Jin Suh , Neung Hwa Park , Young Hwa Chung , Young Sang Lee

ABSTRACT

Background/Aims
- Although the only therapy of proven benefit for chronic hepatitis C is interferon alpha, the rate of sustained response after treatment with interferon is less than 25%. A 6-month course of combination therapy with interferon and ribavirin was associated with higher rate of long-term response than either interferon or ribavirin alone. Pilot studies suggested that combination of interferon and ursodeoxy-cholic acid (UDCA) resulted in higher biochemical response than interferon alone. We investigated the rates of end of treatment response(ETR) and sustained response(SR) of combination therapy of interferon e2a, ribavirin and UDCA and compared it with interferon a 2a alone. Methods' Ninty-five naive patients with chronic hepatitis C who have been positive for anti-HCV by 3rd generation EIA and HCV RNA by RT-PCR and had elevated level of ALT over 6 months were included. They were assigned to three groups. Thirty seven patients in group 1 were treated with interferon a 2a (3MU thrice weekly) in combination with ribavirin (600mg/day) and UDCA (600mg/day) for 6 months. Twenty nine patients in group 2 were treated with the same dose of interferon a 2a alone for 6 months. Changes of ALT and HCV RNA were observed over 12 months (average 3029 mos) after the end of treatment in both groups. Twenty nine patients in group 3 were observed over 12 months without antiviral treatment. HCV genotypes were tested by Innop-Lipa in 24 patients in group 1. Results- In group 1, not only ETR (68%) but also 12 month SR rate (54%) was significantly higher than group 2(31%, 21% respectively). There was no difference in relapse rate between two groups. The level of ALT became normalized and HCV RNA negative within 1 month after treatment in most responders in group l. Genotype 1b was associated with lower ETR and SR than non-lb, although not significant stastistically. Conclusion- Both the ETR and 12 month SR rate were significantly higher after combination treatment of interferon a 2a, ribavirin and UDCA than interferon e 2a alone in chronic hepatitis C. It is suggested that this combination is preferable to interferon alone in the treatment of naive patients with chronic hepatitis C. (Korean J Hepatol 1998;4:109 119)

KeyWords: Chronic hepatitis C , Interferon - α 2a , Ribavirin , Ursodeoxycholic acid ( UDCA )