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Centre for Evidence-
Based Medicine

Chronic hepatitis C - Interferon + Ribavirin increases virological clearance of HCV

Clinical Bottom Line

Interferon + Ribavirin "combination therapy" is significantly more effective than interferon alone or no treatment in clearing HCV.

Citation

Poynard T, Marcellin P, Lee SS, et al. Interferon a2b and ribavirin increased the loss of HCV RNA in chronic hepatitis C. Lancet 1998;352:1426-32.

Clinical Question

In a patient with nonulcer dyspepsia and helicobacter pylori infection, will helicobacter eradication therapy result in a reduction in symptoms of dyspepsia?

Search Terms

"HCV" and "RCT" in Best Evidence

The Study

  • Double-blinded randomised controlled trial with intention-to-treat.
  • Patients >18 years, compensated CHC, naïve to IFN and Ribavirin, Hb>12 (F) 13(M). Exclusions decompensated liver disease or other serious illness.
  • Control group (N = 281; 281 analysed): interferon a2b plus placebo
  • Experimental group (N = 281; 281 analysed): virological status at 24 weeks after the end of treatment.

The Evidence

Outcome CER EER RRR ARR NNT
Viral clearance 0.81 0.57 29 0.23 4
95% Condidence Intervals 0.16 to 0.31 3 to 6

Comments

  1. Poynard's trial results are very similar to those published by McHutchinson based on US data.
  2. The results should be compared with background rates of clearance of HCV in established CHC of ~1%
  3. Drop out rate was low with 80% of patients completing the study

Appraised By

William Rosenberg 1999

Expiry Date

2000