The use of different Peg-interferon α-2b regimens plus ribavirin in HCV-1b-infected patients after r

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Journal of Viral Hepatitis 15 (4) , 300–304

doi:10.1111/j.1365-2893.2007.00944.x

Abstract

The use of different Peg-interferon α-2b regimens plus ribavirin in

HCV-1b-infected patients after rapid virological response does not affect the

achievement of sustained virological response

N. Napoli, G. Giannelli, A. Antonaci and S. AntonaciDepartment of Internal

Medicine, Immunology and Infectious Diseases, Section of Internal Medicine,

University of Bari Medical School, Bari, Italy

Nicola Napoli, Department of Internal Medicine, Immunology and Infectious

Diseases, Section of Internal Medicine, Piazza Giulio Cesare, 11 70124 Bari,

Italy. E-mail: n.napoli@...

Abstract

Summary. In patients with chronic hepatitis C, rapid virological response (RVR)

at week 4 of treatment seems to be strongly associated with a high probability

of achieving a sustained virological response (SVR). The aim of this study was

to investigate the outcome of different pegylated interferon-α2b (Peg-IFN-α2b)

dosages plus ribavirin (RBV) in patients with RVR. Forty-five naïve patients

chronically infected with hepatitis C virus (HCV)-1b started Peg-IFN-α2b (1.5

μg/kg/week) in combination with weight-based RBV doses (800–1200 mg/day).

Thirty-one patients (68.9%) attained RVR at week 4 of therapy, while four

further patients showed negative HCV-RNA values for the first time at week 12

and were considered early virological responders (EVR). The 31 RVR patients were

randomized to receive either RBV plus 1.5 μg/kg/week (17 pts) or 1.0

μg/kg/week (14 pts) of Peg-IFN-α2b for the remaining 44 weeks. The two groups

were matched for age, sex, baseline alanine aminotransferase levels, viral load

and fibrosis score. After 6 months of post-treatment follow-up, the prevalence

of SVR was 94.1% (16/17) among RVR patients treated with 1.5 μg/kg/week and

92.8% (13/14) in RVR patients treated with 1.0 μg/kg/week (P = not

significant). A high-baseline viral load (P = 0.01) and bridging

fibrosis/cirrhosis (P = 0.02) negatively influenced the likelihood of achieving

RVR. On the contrary, the ability of RVR patients to achieve SVR did not

correlate with these baseline characteristics in either of the treatment group.

Finally, the SVR rate among EVR patients who responded after more than 4 weeks

of treatment was significantly lower than among RVR patients (1/4 = 25%vs 29/31

= 93.5%; P = 0.0058), because of a high prevalence of post-treatment relapse

among patients with EVR.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1365-2893.2007.00944.x

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