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Abstract
Objective. Several treatment strategies for patients with chronic hepatitis C have been compared mainly in terms of their efficacy, and it has been found that pegylated interferon (IFN) plus ribavirin has become the standard therapy, but aged patients may not tolerate ribavirin and the cost-effectiveness of treatment should also be further considered. We conducted a study to evaluate the efficacy, safety, and cost-effectiveness of consensus IFN monotherapy with high-dose induction for patients with chronic hepatitis C in clinical practice. Material and Methods. We consecutively enrolled 104 patients with chronic hepatitis C. Patients were scheduled to receive 12 or 18 μg of consensus IFN daily for 2 weeks, then three times a week for 22 weeks. Efficacy, safety, and cost-effectiveness were assessed. A Markov model was developed to investigate cost-effectiveness in patients with chronic hepatitis C treated by different IFN-based treatment strategies. Results. Of the 104 study patients, a sustained virological response (SVR) was achieved in 66 (63%). Logistic regression analysis revealed that genotype 2, lower hepatitis C virus RNA levels, and patient age were independently associated with SVR. The response rate was significantly higher in patients with genotype 2 (51/66, 77%) versus genotype 1 (15/38, 40%). Cost-effectiveness analysis in patients with genotype 2 revealed that high-dose induction with consensus IFN monotherapy was as highly cost-effective as pegylated IFN plus ribavirin. Conclusion. Consensus IFN monotherapy with high-dose induction shows high efficacy and cost-effectiveness in chronic hepatitis C patients with genotype 2 infection. Thus, it may be a reliable alternative in aged patients and for those excluded from standard combination therapy.
Acknowledgements
The authors thank Drs Junnosuke Shimamura, Junichi Inoue, Makoto Watanabe, Toshinari Shimoe, Koji Manabe, Ryuichi Matsuo, Yasuhiro Makino, Satoshi Kiyono, Nobuyuki Sakai, Souhei Ohguchi, Masaki Ohmoto, Kozo Fujio, Shuji Uematsu, Masanobu Miyake, Toshihiko Kaneyoshi, Hajime Wakabayashi, Masatoshi Ogata, Hideaki Taniguchi, Kenji Miyoshi, Hirokazu Miyatake, and Masafumi Inoue, who are the members of the Okayama Hepatitis C Research Group, for contributions to this study. The authors also thank Ms Toshie Ishii for secretarial assistance.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.