Reappearance of HCV-
RNA followed by exacerbation of biochemical parameters after combination
therapy consisting of
interferon and
ribavirin is an obstacle to achieve sustained response and improve long-term prognosis. We hypothesed that
ribavirin monotherapy after 6 months of combination
therapy may improve sustained viral and biochemical responses, and conducted a prospective, randomized and controlled study. Thirty-eight patients with
chronic hepatitis C treated with combination
therapy for 6 months and had no detectable serum HCV-
RNA were enrolled, and allocated into two arms. Group I (n=19) was continuously administered oral
ribavirin for additional 6 months, and group II (n=19) was followed up without any further treatment. At the end of trial, HCV-
RNA negativity was 11/19 (58%) in group I, and 6/19 (32%) in group II (p=0.191). Multivariant analysis demonstrated that
ribavirin monotherapy was not a predictor for the eradication of HCV-
RNA. In cases without sustained viral responses, serum ALT levels at baseline and the end of 48 weeks' trial were 54.6 and 44.4 in group I (p=0.237), and significant reduction with
ribavirin monotherapy was not observed. In conclusion,
ribavirin monotherapy following combination
therapy fails to improve sustained viral response as well as biochemical response.