Ribavirin plus human leucocyte interferon alpha for the treatment of interferon resistant chronic hepatitis C: a controlled trial

A controlled study was carried out on 24 patients with biopsy-proven chronic hepatitis C, who had failed to respond to a previous treatment course with human leukocyte interferon-α (LE-IFNA). The enrolled patients were randomly assigned to receive for 6 months either oral ribavirin, 800 mg daily, plus LE-IFNA, 3 MU thrice a week (Group A: 13 patients), or LE-IFNA alone (Group B: 11 patients). A follow-up period of 6 months was performed in all patients. At enrolment, the two groups showed similar biochemical and histological characteristics. At the end of treatment, normalization of ALT values was found in ten group A patients, five of whom also had undetectable serum HCV-RNA. Only one patient in group B showed such biochemical and virological response. At the end of follow-up, biochemical and virological relapse was registered in all of the Group A patients, whereas the only responding patient in group B still had normal ALT value and undetectable serum HCV-RNA. One group A patient dropped out during the second month of treatment due to development of mild anaemia. In IFN-resistant chronic hepatitis C, the combination therapy of ribavirin and IFNα can induce a complete response during treatment. However, post-treatment relapses are common and long-term benefits seem uncertain.