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Impact of ribavirin plasma level on sustained virological response in patients treated with pegylated interferon and ribavirin for chronic hepatitis C
Author(s) -
BREILH D.,
FOUCHER J.,
CASTÉRA L.,
TRIMOULET P.,
DJABAROUTI S.,
MERROUCHE W.,
COUZIGOU P.,
SAUX M.C.,
DE LÉDINGHEN V.
Publication year - 2009
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2009.04065.x
Subject(s) - ribavirin , medicine , pegylated interferon , hepatitis c virus , gastroenterology , hepatitis c , virology , immunology , virus
Summary Background The main goal of therapy in hepatitis C virus (HCV) infection is to achieve a sustained virological response (SVR). However, the impact of the pharmacological properties of ribavirin on the SVR has not been fully investigated. Aim To evaluate, through a prospective study, the association between ribavirin plasma level and SVR response in HCV patients treated with pegylated interferon (PEG‐IFN) and ribavirin. Patients and methods Patients treated with PEG‐IFN and ribavirin had plasmatic ribavirin dosage at weeks 4 and 12. SVR was evaluated 6 months after the end of treatment. Results At week 4, a strong correlation was found between HCV‐RNA and C min of ribavirin plasma level ( r = −0.376, P = 0.002) and AUC 0→12h of ribavirin plasma level ( r = −0.277, P = 0.018). At week 12, a strong correlation was found between HCV‐RNA and C min of ribavirin plasma level ( r = −0.384, P < 0.0001) and AUC 0→12h of ribavirin plasma level ( r = −0.257, P = 0.002). In genotype 1 patients, AUC 0→12h ribavirin and C min were significantly correlated with negative HCV‐RNA at week 12 and SVR. In the multiple logistic regression model, the only factor independently associated with SVR in genotype 1 patients was negative HCV‐RNA at week 12. Conclusion C min of ribavirin at weeks 4 and 12 was significantly higher in sustained virological responders compared with relapser or nonresponder patients. However, in genotype 1 patients, plasma ribavirin level at weeks 4 and 2 was not associated with SVR.