Longer Therapy May Benefit Subset of Patients With HCV

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Longer Therapy May Benefit Subset of Patients With HCV

NEW YORK (Reuters Health) May 05 - Extended treatment of patients

with hepatitis C virus (HCV) type 1 receiving pegylated-

interferonalfa-2a and ribavirin generally leads no significant

difference in outcome, German researchers report. However, a subset

of patients may benefit.

As lead author Dr. Berg told Reuters Health, " our article fits

in the new concepts of a more individualized treatment strategy in

patients with HCV infection. "

To determine whether treatment extension might benefit patients, Dr.

Berg of Charite Medical University, Berlin and colleagues compared 48

weeks of treatment with 72 weeks of treatment. The findings are

published in the April issue of Gastroenterology.

Two hundred thirty subjects received pegylated-interferon-alfa-2a 180

mcg per week and ribavirin 800 mg per day for 48 weeks. Another group

of 225 patients received the same regimen for 72 weeks. All of the

subjects were treatment-nave.

In the 72-week group, treatment response was seen in 71% patients and

a sustained virologic response at 24 weeks was seen in 53%. In the 48-

week group, corresponding proportions were 63% and 54%.

Despite the lack of significant difference, patients who were still

HCV-RNA positive at week 12 showed significantly higher sustained

virologic response rates when treated for 72 rather than 48 weeks

(29% versus 17%).

The team concludes that extended therapy should be reserved for

patients " with slow virologic response defined as HCV-RNA positive at

week 12 but negative at week 24. "

These slow responders, continued Dr. Berg, " clearly benefit from

extended treatment duration up to 72 weeks. "

However, " it has to be kept in mind that even after extended

treatment duration, slow virologic responders have a greater risk of

relapse after stopping treatment...compared to the rapid responders. "

Gastroenterology 2006;130:1086-1097.

Note: Editorial isn't too helpful and is apparently commenting on at

least 3 studies on the subject in this issue.