Treatment of interferon-α for chronic hepatitis C

Abstract

Combination therapy with polyethylene glycosylated IFN-α_2a or IFN-α_2b and ribavirin is currently the standard therapy for chronic hepatitis C. However, even with this therapy, hepatitis C virus cannot be eradicated in 50% of patients with refractory chronic hepatitis C. In addition, withdrawal or dose reduction occurs in ∼ 40% of patients due to adverse effects. This treatment is also a contraindication in some patients, such as in patients with coexisting diseases or in elderly patients. For these patients, standard IFN-α monotherapy is even safer and more effective. In patients with chronic hepatitis C, IFN-α monotherapy results in a significant increase in the cumulative survival rate by suppressing the progression to hepatocellular carcinoma or liver failure. In addition, other efficacious therapeutic regimens have been employed, such as prolonged administration of standard IFN-α in elderly patients; prolonged low-dose continuous administration in patients with decompensated cirrhosis or hepatocellular carcinoma postoperative patients; and combination therapy with 5-fluorouracil and standard IFN-α for advanced hepatocellular carcinoma. Monotherapy with standard IFN-α should thus be recognised as one of the important therapeutic strategies for chronic hepatitis C.

Keywords::

• chronic hepatitis C
• hepatocellular carcinoma
• IFN-α
• liver cirrhosis
• PEG-IFN-α
• ribavirin

Acknowledgements

The authors thank M Omata (Department of Gastroenterology, Graduate School of Medicine, University of Tokyo) for reading the manuscript critically and for helpful suggestions.

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