Different turnover rate of hepatitis C virus clearance by different treatment regimen using interferon-beta

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J Hepatol 2000 Aug;33(2):313-22

Different turnover rate of hepatitis C virus clearance

by different

treatment regimen using interferon-beta.

Shiratori Y, Perelson AS, Weinberger L, Imazeki F,

Yokosuka O, Nakata

R,

Ihori M, Hirota K, Ono N, Kuroda H, Motojima T,

Nishigaki M, Omata M

Department of Internal Medicine, University of Tokyo,

Japan.

BACKGROUND/AIM: Since patients with high viral load

and HCV subtype 1b

are

known to respond poorly to interferon (IFN) therapy,

the viral dynamics

of

HCV RNA after initiation of interferon therapy were

examined in the

present

study with respect to two different administration

regimens, once vs.

twice

a day. METHODS: Twenty-two patients with chronic

hepatitis C confirmed

by

liver biopsy and with >1 Meq/ml of HCV RNA and HCV

subtype 1b were

randomly

assigned to two different IFN administration regimens

(6 million units

of

IFN once a day or 3 million units of IFN twice a day),

and the serum

HCV RNA

level was serially measured. RESULTS: Graphs of HCV

RNA levels vs.

treatment

time showed an initial rapid fall, followed by a

slower clearance

phase.

Fitting the data to a model for HCV decay proposed by

Neumann et al.

showed

that the treatment efficacy was significantly higher

with twice daily

administration. Negativity for HCV RNA measured by

Amplicor assay in

the

twice-a-day administration group was 18%, 73% and >89%

at 1, 2 and 3

weeks,

respectively, in contrast to 0%, 0%, and 18%,

respectively, with

once-a-day

administration. However, a significant reduction of

platelet count and

albumin level, a marked increase in serum aspartate

aminotransferase/alanine

aminotransferase, and a high incidence of renal

toxicity (proteinuria)

were

found in patients receiving IFN twice a day in

comparison with those

receiving it once a day. CONCLUSION: The twice-a-day

administration of

IFN

accelerated the clearance of HCV RNA from serum,

leading to a more

efficient

virological response for patients with chronic

hepatitis C, but with a

high

rate of renal toxicity.

PMID: 10952250, UI: 20406782

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