***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Hepatitis C virus ( HCV ) genotyping has been shown to predict response to interferon  , but is expensive . HCV serotyping is less expensive and simpler , and may be similarly useful . Using data from a large , r and omized trial comparing consensus interferon ( CIFN ) and interferon alfa-2b ( IFN alfa-2b ) in patients with chronic HCV , we evaluated response rates based on HCV serotypes versus genotypes . Patients included in this analysis received subcutaneous injection of 9 microg CIFN ( n = 232 ) or  3 MU IFN alfa-2b ( n = 240 ) three times weekly for 24 weeks followed by 24 weeks of observation . Serum HCV RNA concentrations were measured regularly during treatment and at the end of both the treatment and post-treatment periods . Response to interferon  was similar for HCV antibody types and their corresponding genotypes . The end-of-treatment HCV RNA rate of response ( defined as undetectable serum on two consecutive assessment s ) was 29 % for serotype 1 versus 24 % for genotype 1 after CIFN ; and 14 % versus 15 % , respectively , after IFN alfa-2b . Independently of treatment , patients infected with serotype or genotype 2 or 3 had a better therapeutic response than those infected with serotype or genotype 1 . Similar results were obtained based on HCV antibody typing and genotyping , suggesting the potential of the former for predicting response to interferon The treatment of chronic hepatitis C patients was enhanced when the combination of interferon alfa-2b and ribavirin was shown to be safe and more effective than interferon monotherapy . To date , no published reports have addressed the use of consensus interferon ( CIFN ) when combined with ribavirin . We conducted a pilot study to compare the safety and tolerability of daily CIFN plus ribavirin to CIFN monotherapy for the initial treatment of chronic hepatitis C patients . Forty subjects were r and omized to two treatment groups ;  CIFN 9 microg daily , or CIFN 9 microg daily plus ribavirin 1000 or 1200 mg daily . All subjects received 48 weeks of therapy except for nongenotype 1 subjects in the combination treatment group who received only 24 weeks of therapy . The results show that at baseline , age , gender , risk factors , race , RNA titres , and liver histology were not different between the two groups . The proportion of subjects with genotype 1 infection was 50 % ( 10/20 ) and 55 % ( 11/20 ) for the monotherapy and combination therapy groups , respectively . Fifty ( 10/20 ) and sixty-five ( 13/20 ) per cent of subjects in the monotherapy and combination therapy groups exhibited a 2-log or greater decrease in viral titre at week 12 ( P = NS ) . Using intent-to-treat analysis , 20 % and 40 % of enrolled subjects exhibited a sustained viral response in the monotherapy and combination therapy groups , respectively ( P = NS ) . The proportion of subjects requiring dose reduction was 55 % ( 11/20 ) and 65 % ( 13/20 ) , respectively . Study discontinuations for any reason were 25 % ( 5/20 ) and 35 % ( 7/20 ) for the monotherapy and combination groups , respectively . Discontinuations due to adverse events related to study drug were 20 % ( 4/20 ) and 25 % ( 5/20 ) , respectively . A total of four serious adverse events occurred , two in each treatment group , only one of which was determined to be study -drug related . It is concluded that the safety and tolerability profiles of the two treatments were similar suggesting that daily dosing of CIFN may be difficult to tolerate result ing in discontinuation of therapy in a significant proportion of patients . The combination regimen result ed in a trend towards a higher viral response rate than monotherapy treatment . These data suggest that CIFN may be safely combined with ribavirin and may enhance the sustained response rate but is not well tolerated in US patients when given in a daily dosing regimen CONTEXT The Consoli date d St and ards for Reporting of Trials ( CONSORT ) statement was developed to help improve the quality of reports of r and omized controlled trials ( RCTs ) . To date , a paucity of data exists regarding whether it has achieved this goal . OBJECTIVE To determine whether use of the CONSORT statement is associated with improvement in the quality of reports of RCTs . DESIGN AND SETTING Comparative before- and -after evaluation in which reports of RCTs published in 1994 ( pre-CONSORT ) were compared with RCT reports from the same journals published in 1998 ( post-CONSORT ) . We included 211 reports from BMJ , JAMA , and The Lancet ( journals that adopted CONSORT ) as well as The New Engl and Journal of Medicine ( a journal that did not adopt CONSORT and was used as a comparator ) . MAIN OUTCOME MEASURES Number of CONSORT items included in a report , frequency of unclear reporting of allocation concealment , and overall trial quality score based on the Jadad scale , a 5-point quality assessment instrument . RESULTS Compared with 1994 , the number of CONSORT checklist items in reports of RCTs increased in all 4 journals in 1998 , and this increase was statistically significant for the 3 adopter journals ( pre-CONSORT , 23.4 ; mean change , 3.7 ; 95 % confidence interval [ CI ] , 2.1 - 5.3 ) . The frequency of unclear reporting of allocation concealment decreased for each of the 4 journals , and this change was statistically significant for adopters ( pre-CONSORT , 61 % ; mean change , -22 % ; 95 % CI , -38 % to -6 % ) . Similarly , 3 of the 4 journals showed an improvement in the quality score for reports of RCTs , and this increase was statistically significant for adopter journals overall ( pre-CONSORT , 2.7 ; mean change , 0.4 ; 95 % CI , 0.1 - 0.8 ) . CONCLUSION Use of the CONSORT statement is associated with improvements in the quality of reports of RCTs A significant proportion of patients with chronic hepatitis C virus ( HCV ) infection who undergo antiviral therapy  have persistent or recurrent viremia and fail to achieve a sustained  virologic response  (  SVR ) . Factors associated with treatment failure include HCV genotype 1 infection , high serum HCV RNA levels , and advanced fibrosis .  Consensus interferon ( CIFN ) is a synthetic type I interferon derived from a consensus sequence of the most common amino acids found in naturally occurring alpha interferon subtypes . Several prospect i ve clinical studies have demonstrated that CIFN may be a treatment option in patients who have failed prior interferon-based therapy , including those who have failed combination therapy with st and ard interferon or peginterferon plus ribavirin .  Daily CIFN in combination with ribavirin may be an effective regimen in this setting ; however , optimal dose and treatment duration of CIFN therapy have not been well established . Patients who achieve viral suppression during prior interferon-based therapy and those who do not have advanced fibrosis have a greater likelihood of achieving a SVR with CIFN retreatment . Individualized therapy targeting specific patient groups will be an important consideration in the successful management of prior treatment failures . Additional prospect i ve studies are required in order to identify optimal treatment strategies for the use of CIFN in these patients Recently , lactoferrin has been reported to have anti-HCV effects . The aim of this study was to investigate the effect of combination therapy using consensus interferon ( CIFN ) and lactoferrin in patients with chronic hepatitis C. Twenty-one patients with chronic HCV infection , who were positive for HCV-RNA genotype 1b with serum viral loads from 100 to 700KIU/ml , were r and omly assigned to two groups ; the CIFN + Lac group received CIFN with lactoferrin and the CIFN group received CIFN alone .  Nine patients in each group completed this trial ; the other patients dropped out because of side effects .  Three , two and four patients were categorized as complete responders , relapsers and non-responders , respectively , in the CIFN + Lac group , and four , one and four in the CIFN group , respectively . There was no statistically significant difference in virologic response between the two groups . During the follow up after CIFN therapy with continued lactoferrin , there were two relapsers in the CIFN + Lac group and their HCV-RNA titers before treatment were over 400KIU/ml . In conclusion , the combination therapy of CIFN and lactoferrin did not increase the response rate or prevent relapse after discontinuation of IFN The likelihood of a sustained response to a course of interferon in patients with chronic hepatitis C correlates with several clinical and viral factors , including age , viral genotype and initial levels of hepatitis C virus ( HCV ) RNA in serum . The role of race and ethnicity has not been assessed . We evaluated the association of race with response to interferon  in a large r and omized , controlled trial using either consensus interferon ( 9 μg ) or interferon alfa‐2b ( 3 million units ) given three times weekly for 24 weeks . African‐American patients participating in the study were similar to white patients in mean age ( 43 vs. 42 years ) and baseline levels of HCV RNA ( 3.6 vs. 3.0 million copies/mL ) but had lower rates of cirrhosis ( 5 % vs. 12 % ) and more frequently had viral genotype 1 ( 88 % vs. 66%:P= .004 ) . Most strikingly , the rates of end‐of‐treatment and sustained virological responses were lower among the 40 African‐American patients ( 5 % and 2 % ) than among the 380 white patients ( 33 % and 12 % ) ( P= .04 and .07 ) . Rates of response among Hispanic and Asian‐American patients were not statistically different than non‐Hispanic white patients . Median viral levels decreased by week 24 of therapy by 2.5 logs in white patients ( from 3.0 to 0.012 million copies/mL ) but by only 0.5 logs among African‐ American patients ( from 3.6 to 1.8 million copies/mL ) . Thus , there are marked racial differences in virological responses to interferon in hepatitis C that must be considered in assessing trials of interferon therapy and in counseling patients regarding treatment . The differences in response rates are as yet unexplained BACKGROUND & AIMS Liver fibrosis is an important prognostic factor in patients with hepatitis C. The effect of pegylated ( PEG ) interferon alone or its combination with ribavirin on fibrosis has not been established . METHODS We pooled individual data from 3010 naive patients with pretreatment and posttreatment biopsies from 4 r and omized trials . Ten different regimens combining st and ard interferon , PEG interferon , and ribavirin were compared . The impact of each regimen was estimated by the percentage of patients with at least 1 grade improvement in the necrosis and inflammation ( METAVIR score ) , the percentage of patients with at least 1 stage worsening in fibrosis METAVIR score , and by the fibrosis progression rate per year . RESULTS Necrosis and inflammation improvement ranged from 39 % ( interferon 24 weeks ) to 73 % ( optimized PEG 1.5 and ribavirin ; P < 0.001 ) . Fibrosis worsening ranges from 23 % ( interferon 24 weeks ) to 8 % ( optimized PEG 1.5 and ribavirin ; P < 0.001 ) . All regimens significantly reduced the fibrosis progression rates in comparison to rates before treatment . The reversal of cirrhosis was observed in 75 patients ( 49 % ) of 153 patients with baseline cirrhosis . Six factors were independently associated with the absence of significant fibrosis after treatment : baseline fibrosis stage ( odds ratio [ OR ] = 0.12 ; P < 0.0001 ) , sustained viral response ( OR = 0.36 ; P < 0.0001 ) , age < 40 years ( OR = 0.51 ; P < 0.001 ) , body mass index < 27 kg/m(2 ) ( OR = 0.65 ; P < 0.001 ) , no or minimal baseline activity ( OR = 0.70 ; P = 0.02 ) , and viral load < 3.5 millions copies per milliliter ( OR = 0.79 ; P = 0.03 ) . CONCLUSIONS PEG-interferon and ribavirin combination significantly reduces the rate of fibrosis progression in patients with hepatitis BACKGROUND Only 15 to 20 percent of patients with chronic hepatitis C have a sustained virologic response to interferon therapy . We compared the efficacy and safety of recombinant interferon alfa-2b alone with those of a combination of interferon alfa-2b and ribavirin for the initial treatment of patients with chronic hepatitis C. METHODS We r and omly assigned 912 patients with chronic hepatitis C to receive st and ard-dose interferon alfa-2b alone or in combination with ribavirin ( 1000 or 1200 mg orally per day , depending on body weight ) for 24 or 48 weeks . Efficacy was assessed by measurements of serum hepatitis C virus ( HCV ) RNA and serum amin 
    Output:
    
Conclusions High dose daily induction therapy with CIFN is not superior to low dose therapy in terms of SVR .
It seems that 9 μg tiw is the optimal treatment dose of CIFN for treatment of HCV infection .