Interferon and ribavirin vs. interferon alone in the re-treatment of chronic hepatitis C

Combination therapy with interferon and higher-dose ribavirin (1 000 to 1 200 mg/day), for at least 24 weeks, appears to be more effective than interferon alone in the re-treatment of interferon non-responders. However, the response rates remain low (less than 20%).

A systematic review including 12 studies with a total of 941 subjects was abstracted in DARE. The pooled virological response rate for combination therapy was 14% (95% CI: 11 to 17), with a risk difference of 7% (95% CI: 2 to 13) in favour of combination therapy. Use of IFN alfa-2a/2b and 1 000 to 1 200 mg/day ribavirin was associated with a pooled virological response rate of 18% and a risk difference of 16% (95% CI: 11 to 21). The risk difference was 0% (95% CI: -7 to +7) when IFN alfa-n/n3 and a lower dose of ribavirin (600 to 800 mg/day) were used. Combination therapy was associated with more adverse effects (9 studies) with a risk difference of 4% (95% CI: 1 to 7). The pooled withdrawal rate was 9% (95% CI: 7 to 12) for combination therapy, compared with 4% (95% CI: 3 to 7) for monotherapy. No treatment-related deaths were reported.

Ədəbiyyat

1. Cummings KJ, Lee SM, West ES, Cid-Ruzafa J, Fein SG, Aoki Y, Sulkowski MS, Goodman SN. Interferon and ribavirin vs interferon alone in the re-treatment of chronic hepatitis C previously nonresponsive to interferon: A meta-analysis of randomized trials. JAMA 2001 Jan 10;285(2):193-9.