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Effects of ribavirin combined with interferon‐ α 2b on viral kinetics during first 12 weeks of treatment in patients with hepatitis C virus genotype 1 and high baseline viral loads
Author(s) -
Enomoto M.,
Nishiguchi S.,
Kohmoto M.,
Tamori A.,
Habu D.,
Takeda T.,
Seki S.,
Shiomi S.
Publication year - 2004
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2004.00524.x
Subject(s) - ribavirin , hepatitis c virus , viral load , interferon , medicine , combination therapy , gastroenterology , genotype , virology , virus , immunology , biology , gene , biochemistry
Summary. This study aimed to find how ribavirin increases viral disappearance in patients with hepatitis C virus (HCV) of genotype 1 and high baseline viral loads (>5.0 ×10 5 copies/mL) when given with interferon (IFN). Using the real‐time quantitative polymerase chain reaction, we measured serum HCV in 20 patients during the first 12 weeks of therapy with IFN‐ α 2b and ribavirin. Controls were 10 similar patients given IFN‐ α 2b alone. IFN‐ α 2b was given at 6 MU daily for 2 weeks, and then three times weekly. Ribavirin was given at 600 or 800 mg daily. Serum HCV RNA decreased rapidly in the first phase, during the first 24 h of therapy (day 0), and more slowly in the early second phase (days 1–14). The median decrease was by 1.41 and 0.078 log 10/day in these two phases in the combination therapy group, and 0.90 and 0.081 log 10/day in the monotherapy group. The difference between groups in the first phase was not significant ( P = 0.24), nor was that in the next phase ( P = 0.68). Later in the second phase, between days 14 and 84, the median decrease was larger in the combination therapy group (0.030 log 10/day) than in the monotherapy group (0.015 log 10/day, P = 0.035). In patients with HCV genotype 1 and high viral loads, the effects of ribavirin with IFN‐ α appeared slowly, after the earliest days of treatment. A long‐term favourable outcome of combination therapy may be associated with a rapid viral decline in this later phase of therapy.