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AIM To report on the efficacy, safety and tolerability of interferon alfa-2a combined with a “low dose” of ribavirin for relapsers and non-responders to alpha interferon monotherapy.METHODS Thirty-four chronic hepatitis C virus-infected non-responders to interferon alfa-2a monotherapy (a course of at least 3 months treatment) and 13 relapsers to interferon alfa-2a monotherapy (a dose of 3 to 6 million units three times per week for at least 20 weeks but not more than 18 months) were treated with the same dose of interferon alfa-2a used before (3 to 6 million units three times per week) and ribavirin (10mg/kg daily) for 6 months. Incomplete responders, interferon alfa-2a wasadministered for further 6 months at the same dose used before as monotherapy.RESULTS Seven (20.6%) of 34 non-responders stopped the combined therapy due to adverse events, including two patients with histological and clinical Child A cirrhosis. In 17/27 (63%) nonresponders, the combined therapy was stopped after three months because of non-response. Ten of the 27 non-responders completed the 12-month treatment course. At a mean follow up of 28 months (16-37 months) after the treatment, 4/10 (15%) previous non-responders still remained complete responders. All 13 previous relapsers completed the 12-month treatment course. At a mean follow up of 22 months (9-36 months) after treatment. 6/13(46%) the previous relapsers were still sustained complete responders.CONCLUSION Our treatment schedule of the combined therapy for 6 months of interferon alfa-2a with a low dose of ribavirin (10mg/kg/day) followed by 6 months of interferon alfa-2a monotherapy is able to induce a sustained complete response rate in 15% of non-responders and 46% of relapsers with chronic hepatitis C virus-related liver diseases comparable to those obtained with the standard doses of ribavirin 1000-1200 mg/day.Randomized prospective controlled trials using lower total amounts of ribavirin in combinationwith interferon should be performed.
AIM To report on the efficacy, safety and tolerability of interferon alfa-2a combined with a “low dose” of ribavirin for relapsers and non-responders to alpha interferon monotherapy. METHODS Thirty-four chronic hepatitis C virus-infected non-responders to interferon alfa-2a monotherapy (a course of at least 3 months treatment) and 13 relapsers to interferon alfa-2a monotherapy (a dose of 3 to 6 million units three times per week for at least 20 weeks but not more than 18 months) were treated with the same dose of interferon alfa-2a used before (3 to 6 million units three times per week) and ribavirin (10 mg / kg daily) for 6 months. Incomplete responders, interferon alfa-2a wasadministered for further 6 months at the same dose used before as monotherapy .RESULTS Seven (20.6%) of 34 non-responders stopped the combination therapy due to adverse events, including two patients with histological and clinical Child A cirrhosis. In 17/27 (63%) nonresponders, the combined therapy was stopped after t Ten of the 27 non-responders completed the 12-month treatment course. At a mean follow up of 28 months (16-37 months) after the treatment, 4/10 (15%) previous non All 13 previous relapsers were the 12-month treatment course. At a mean follow up of 22 months (9-36 months) after treatment. 6/13 (46%) the previous relapsers were still adequate complete responders.CONCLUSION Our treatment schedule of the combined therapy for 6 months of interferon alfa-2a with a low dose of ribavirin (10 mg / kg / day) followed by 6 months of interferon alfa-2a monotherapy is able to induce a sustained complete response rate in 15% of non-responders and 46% of relapsers with chronic hepatitis C virus-related liver diseases comparable to those obtained with the standard doses of ribavirin 1000-1200 mg / day. Randomized prospective controlled trials using lower total amounts of ribavirin in combinationwith interferon should beperformed.