High-Dose Interferon Alfacon-1 for Hepatitis C

A study has demonstrated that high-dose interferon alfacon-1 given for 24 weeks cleared the hepatitis C virus (HCV) from the blood of 80% of infected patients for whom conventional interferon-based therapy had not worked. The study was conducted by Maria Sjogren, M.D., a hepatologist at the Walter Reed Army Medical Center in Washington, DC (USA).

The study involved 554 relapsers with chronic HCV infection who had received interferon alpha-2b three times weekly plus the antiviral drug ribavirin. Three-fourths of these patients had shown temporary responses, in that HCV levels diminished and then returned. The therapy had no effect on the other one-fourth of patients.

The 554 patients were started on interferon alfacon-1 at 15 mcg daily for eight weeks and then randomized to one of two high-dose regimens: 15 mcg three times weekly or 9 mcg a day. More than 80% of those who had relapsed on prior combination therapy showed no trace of HCV after eight weeks on the 15 mcg-a-day regimen. After continued treatment from week nine to week 24, 81% of those who received interferon alfacon-1 at 9 mcg daily and 60% of those who received 15 mcg three times a week were HCV-negative.

For those patients who had not responded at all to prior combination therapy, viral response rates at 24 weeks were somewhat lower but still substantial: 37% for those treated with 9 mcg a day and 22% for those treated with 15 mcg thrice weekly. The high-dose regimen was less effective at eliminating HCV from patients who initially had greater viral loads than from patients with lower viral loads, according to Dr. Sjorgren. Still, she observed, the ones who had a lot of virus did not do badly at all. This finding suggests that even previously treated patients with persistent high HCV viral loads might benefit from high-dose interferon alfacon-1 (Infergen, Amgen) therapy.