MRC Notes

This series is based on notes that I took when I attended the Medical Research Council (MRC) HCV Conference in Ottawa on January 15 &16, 1999. While every attempt has been made to maintain accuracy, you must keep in mind that these are only my personal notes.

Darlene Morrow

By Dr. Sam Lee, MD

Univ. of Calgary,

Health Sciences Center,

3330 Hospital Drive NW

Calgary, Alberta T2N 4N1

Tel:403-220-8457

Fax:403-270-0995

At the current time we have the following treatment available for hepatitis C:

• Alpha interferon
• Lymphoblastoid interferon
• Consensus interferon
• Pegylated interferon
• Interferon 2a and 2b
• Beta interferon (Asia, Japan)
• Ribavirin
• Alpha thymosin, interleukins, UDCA

Definitions of Hepatitis C Participants in Clinical Studies

• Non responders-failed to clear HCV RNA
• Relapsers-clear HCV RNA but fail to maintain this clearance.
• Sustained responder- negative for HCV RNA at six months post treatment

Monotherapy in Treatment Naive Patients

• 25-30% have a sustained response following 24 weeks of combination treatment
• 5-10% had a sustained response to interferon alone at 24 weeks or 15% at 48 weeks

How sustained is sustained?

• We can look at the retrospective data with Paula what periods of between 2-15 years.
• Of those that are negative at six months approximately 60-90% are still negative in four years.
• No data on the combo

Interferon And Ribavirin Combination Therapy In Treatment Naive Patients

• The response rate is doubled in genotype 1b

Parameters that increase the treatment response include:

• Genotype none 1
• Low viremia
• Rapid HCV clearance

The Treatment Of Patients With Normal ALTs

• At this point there is no treatment of patients with normal liver enzymes. We estimate that this represents at least 40% of the patients we see.

The Treatment of Patients with Advanced HCV

• The reponse reate decrease by betweeen 1/3 to 1/2.

The Treatment of Children

• no treatment at this time.

HepC BC