Interferon-gamma with peginterferon alpha-2a and ribavirin in nonresponder patients with chronic hepatitis C (ANRS HC16 GAMMATRI).
Fiche publication
Date publication
février 2013
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BRONOWICKI Jean-Pierre
Tous les auteurs :
Couzigou P, Perusat S, Bourliere M, Trimoulet P, Poynard T, Leroy V, Marcellin P, Foucher J, Bronowicki JP, Chene G
Lien Pubmed
Résumé
BACKGROUND AND AIM: Interferon-gamma-1b (IFN-gamma-1b) improves alpha interferon (IFN-alpha) inhibition of hepatitis C virus (HCV) replication in replicon system. We described virological response after addition of IFN-gamma to a combination of ribavirin/peginterferon (PEG-IFN)-alpha-2a or alpha-2b. METHODS: In this non-comparative, multicenter trial, patients chronically infected by HCV who were nonresponders to a previous treatment by PEG-IFN and ribavirin were restarted on a regimen of PEG-IFN-alpha-2a (180 mug/week) + ribavirin (1000-1200 mg/day) for 16 weeks. If HCV-RNA decreased less than 2 log(10) copies/mL (nonresponders), and if PEG-IFN-alpha-2a and ribavirin dosages were unchanged while tolerance was good, IFNgamma-1b (100 mug three times per week) was added for the last 32 weeks of treatment. Virological response was evaluated at week 28 (12 weeks after initiation of IFN-gamma-1b). RESULTS: Among the 48 patients started on dual therapy, 23 patients (47%) were nonresponders at week 12 and received IFN-gamma-1b from week 16 onward. Their mean HCV-RNA (log(10) IU/mL) was 6.83 at baseline, 5.81 at week 12, and 5.63 at week 28. No patient reached undetectable HCV-RNA at week 28 (upper bound of 95% confidence interval: 14.8%); none had a decrease > 1 log(10) IU/mL. One case of grade 4 neutropenia was reported. CONCLUSION: Among the strictly selected nonresponders, IFN-gamma-1b (at a dosage of 100 mug thrice a week) in combination with PEG-IFN-alpha-2a and ribavirin failed to show virological efficacy.
Référence
J Gastroenterol Hepatol. 2013 Feb;28(2):329-34