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Lead‐in treatment with interferon‐β/ribavirin may modify the early hepatitis C virus dynamics in pegylated interferon alpha‐2b/ribavirin combination for chronic hepatitis C patients with the IL28B minor genotype
Author(s) -
Itokawa Norio,
Atsukawa Masanori,
Tsubota Akihito,
Kondo Chisa,
Hashimoto Satomi,
Fukuda Takeshi,
Matsushita Yoko,
Kidokoro Hideko,
Kobayashi Tamaki,
Narahara Yoshiyuki,
Nakatsuka Katsuhisa,
Kanazawa Hidenori,
Iwakiri Katsuhiko,
Sakamoto Choitsu
Publication year - 2013
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12039
Subject(s) - ribavirin , medicine , pegylated interferon , hepatitis c virus , viral load , interferon , interleukin 28b , gastroenterology , genotype , alpha interferon , immunology , peg ratio , hepatitis c , virology , virus , biology , gene , biochemistry , finance , economics
Background and Aim The most important factor influencing the effect of pegylated interferon ( PEG‐IFN )/ribavirin therapy ( PEG ) for chronic hepatitis C genotype 1b with high viral load is the interleukin 28B ( IL28B ) genotype. We investigated the usefulness of lead‐in twice‐daily interferon ( IFN )‐β/ribavirin therapy ( IFN ‐β), and the early hepatitis C virus RNA (HCV‐RNA) dynamics was compared between PEG and IFN ‐β groups according to the IL28B genotype. Methods Forty‐six patients were randomly allocated to PEG and IFN ‐β groups, and HCV‐RNA dynamics in an early phase of treatment were analyzed. Results The patients with minor IL28B genotype was 6/23 and 8/23 in IFN ‐β and PEG groups, respectively. In the patients with IL28B major genotype, viral load reduction was marginally greater in IFN ‐β group than in PEG group. In contrast, in the patients with the IL28B minor genotype, viral load reduction was significantly and numerically greater in IFN ‐β group than in PEG group at 1 week (2.07 vs 0.76 log IU /m L , P = 0.038), 2 weeks (2.73 vs 1.01, P = 0.009), 4 weeks (2.72 vs 1.55, P = 0.059), and 12 weeks (4.56 vs 3.24, P = 0.104). The sustained virological response rates in the IL28B major genotype were similar between IFN ‐β group (47.1%, 8/17) and PEG group (53.3%, 8/15). In contrast, the sustained virological response rates in the IL28B minor genotype were numerically higher in IFN ‐β group (50.0%, 3/6) than in PEG group (12.5%, 1/8), although not statistically significant. Conclusion It was suggested that lead‐in twice‐daily IFN ‐β/ribavirin treatment followed by PEG‐IFN /ribavirin combination therapy may modify the HCV‐RNA dynamics compared with that by PEG‐IFN /ribavirin therapy, and it is particularly useful for the IL28B minor genotype.