In the Journals

Low-dose interferon more effective in preventing relapse among HCV patients with mild fibrosis

Low-dose oral interferon could be more effective than other treatments for reducing the risk for hepatitis C virus relapse in patients with mild liver fibrosis, according to a recent study.

In a double blind study, researchers analyzed 169 chronic HCV patients with genotype 1b who had been treated with pegylated interferon-alfa and ribavirin. They were randomly assigned interferon-alfa lozenges at 500 IU per day (n=59), 1,500 IU per day (n=53) or placebo (n=57) for 24 weeks.

Overall, relapse occurred in 18 (30.5%), 20 (37.7%), and 20 (35.1%) of low-dose, high-dose, and placebo groups, respectively (P=.716).

When relapse was stratified by a patient’s fibrosis index between 1.4 and 1.7, one of 12 patients in the low-dose group experienced HCV relapse compared with four of nine in the high-dose group and five of 12 placebo patients (P=.05).

Low-dose interferon also significantly improved platelet recovery, as compared with the high-dose and placebo groups. After 48 weeks, low-dose patients had a platelet count of 203.4 ± 52.7 x 103/mcL vs. 167.6 ± 59 x 103/mcL for the placebo group (P=.003), with virtually no difference between the placebo and high-dose groups.

Thrombocytopenic patients, who had platelet counts less than 150 x 103/mcL, saw a similar pattern, with low-dose patients recovering faster than the placebo group (P=.002) at 48 weeks.

No significant increases in adverse events were observed between treated patients and the placebo group.

While the platelet count increase was seen in nearly all members of the low-dose group, the lower relapse rate in patients with mild fibrosis was seen in a small sample size because of stratification across fibroindex levels.

“A larger scale of study that focuses on patients with mild fibrosis is needed to further clarify this issue,” the researchers wrote.

Disclosure: The researchers report no relevant financial disclosures.