Hepatitis C virus relapse was suppressed by long-term self-injection of low-dose interferon in patients with chronic hepatitis C after pegylated interferon plus ribavirin treatment

Aim The recommended treatment for chronic hepatitis C is a combination of pegylated interferon (PEG IFN) plus ribavirin (RBV). However, the sustained virological response (SVR) rate of PEG IFN-RBV therapy was approximately 50% in patients with genotype 1b and a high viral load. Thus, we compared the efficiencies and side-effects of PEG IFN-RBV and self-injected low-dose natural (n) IFN- in patients with hepatitis C virus (HCV). Methods A prospective, multicenter, open-label study was conducted in 12 Japanese institutions. A total of 129 patients with chronic hepatitis C and no detectable HCV after 24-72 weeks of PEG IFN-RBV treatment were assigned to the control (n=82) or treated (n=47) group. Treated patients received 3 million units of nIFN- 2-3 times/week over 96 weeks. The groups were compared regarding treatment efficiency and side-effects. Results Significant treatment success regarding virus negativation rates was found, with 89% and 73% for the treated and control groups, respectively (P=0.039). In contrast, there was no difference in relapse rate between the groups 24 weeks after the 96-week nIFN- treatment (P=0.349). However, when early viral responders and late viral responders (LVR) were separated, LVR patients responded significantly to the treatment with 90% sustained virological response, compared to 53% for the control group (P=0.044). The side-effects of nIFN- were less than that of PEG IFN-RBV treatment. Conclusion Self-injected nIFN- has larger benefits than prolonged PEG IFN-RBV for chronic hepatitis C patients with high viral loads of genotype 1b who fail to achieve early viral response during initial combination treatment.