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New proposal for response‐guided peg‐interferon‐plus‐ribavirin combination therapy for chronic hepatitis C virus genotype 2 infection
Author(s) -
Abe Hiroshi,
Aida Yuta,
Ishiguro Haruya,
Yoshizawa Kai,
Seki Nobuyoshi,
Miyazaki Tamihiro,
Itagaki Munenori,
Sutoh Satoshi,
Ika Makiko,
Kato Keizo,
Shimada Noritomo,
Tsubota Akihito,
Aizawa Yoshio
Publication year - 2013
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.23626
Subject(s) - ribavirin , medicine , hepatitis c virus , viral load , virology , combination therapy , immunology , gastroenterology , genotype , hepacivirus , virus , pegylated interferon , biology , biochemistry , gene
This study aimed to determine the most suitable duration of pegylated‐interferon (Peg‐IFN)‐plus‐ribavirin combination therapy in patients infected with hepatitis C virus (HCV) genotype 2 who had not achieved rapid virological response (serum HCV RNA disappearance after 4 weeks of therapy). HCV genotype 2 patients (n = 182) with a high viral load received >80% of the standard Peg‐IFN‐plus‐ribavirin dose for at least 24 weeks, and their final virological responses were studied. Patients were classified into “rapid virological response” and “non‐rapid virological response” groups. The non‐rapid virological response group was further divided into a “virological response at 8 weeks” (serum HCV RNA disappearance after 8 weeks of therapy) and a “non‐virological response at 8 weeks” group. Factors related to rapid virological response and optimal therapy duration in the non‐rapid virological response group were evaluated. Multivariate logistic regression analysis showed that subtype HCV genotype 2a ( P = 0.0015) and low concentration of pretreatment serum HCV RNA ( P = 0.0058) were independent factors in a rapid virological response. In the virological response at 8 weeks group, the sustained virological response rate after 24 weeks of therapy was significantly lower than after 36 weeks ( P = 0.044) or after 48 weeks ( P = 0.006), and was similar for 36‐ and 48‐weeks. The cost for achieving (CAS) one sustained virological response was lowest with 36‐week therapy. Prolongation of Peg‐IFN‐plus‐ribavirin combination therapy to 36 weeks is suitable for achieving virological response at 8 weeks, given the high, sustained virological response rate and cost benefit. J. Med. Virol. 85:1523–1533, 2013 . © 2013 Wiley Periodicals, Inc.