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The use of different Peg-interferon alpha-2b regimens plus ribavirin in HCV-1b-infected patients after rapid virological response does not affect the achievement of sustained virological response.
J Viral Hepat 2008; 15(4):300-4JV

Abstract

In patients with chronic hepatitis C, rapid virological response (RVR) at week 4 of treatment seems to be strongly associated with a high probability of achieving a sustained virological response (SVR). The aim of this study was to investigate the outcome of different pegylated interferon-alpha2b (Peg-IFN-alpha2b) dosages plus ribavirin (RBV) in patients with RVR. Forty-five naïve patients chronically infected with hepatitis C virus (HCV)-1b started Peg-IFN-alpha2b (1.5 microg/kg/week) in combination with weight-based RBV doses (800-1200 mg/day). Thirty-one patients (68.9%) attained RVR at week 4 of therapy, while four further patients showed negative HCV-RNA values for the first time at week 12 and were considered early virological responders (EVR). The 31 RVR patients were randomized to receive either RBV plus 1.5 microg/kg/week (17 pts) or 1.0 microg/kg/week (14 pts) of Peg-IFN-alpha2b for the remaining 44 weeks. The two groups were matched for age, sex, baseline alanine aminotransferase levels, viral load and fibrosis score. After 6 months of post-treatment follow-up, the prevalence of SVR was 94.1% (16/17) among RVR patients treated with 1.5 microg/kg/week and 92.8% (13/14) in RVR patients treated with 1.0 microg/kg/week (P = not significant). A high-baseline viral load (P = 0.01) and bridging fibrosis/cirrhosis (P = 0.02) negatively influenced the likelihood of achieving RVR. On the contrary, the ability of RVR patients to achieve SVR did not correlate with these baseline characteristics in either of the treatment group. Finally, the SVR rate among EVR patients who responded after more than 4 weeks of treatment was significantly lower than among RVR patients (1/4 = 25%vs 29/31 = 93.5%; P = 0.0058), because of a high prevalence of post-treatment relapse among patients with EVR.

Authors+Show Affiliations

Department of Internal Medicine, Immunology and Infectious Diseases, Section of Internal Medicine, University of Bari Medical School, Bari, Italy. n.napoli@intmed.uniba.itNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18307592

Citation

Napoli, N, et al. "The Use of Different Peg-interferon Alpha-2b Regimens Plus Ribavirin in HCV-1b-infected Patients After Rapid Virological Response Does Not Affect the Achievement of Sustained Virological Response." Journal of Viral Hepatitis, vol. 15, no. 4, 2008, pp. 300-4.
Napoli N, Giannelli G, Antonaci A, et al. The use of different Peg-interferon alpha-2b regimens plus ribavirin in HCV-1b-infected patients after rapid virological response does not affect the achievement of sustained virological response. J Viral Hepat. 2008;15(4):300-4.
Napoli, N., Giannelli, G., Antonaci, A., & Antonaci, S. (2008). The use of different Peg-interferon alpha-2b regimens plus ribavirin in HCV-1b-infected patients after rapid virological response does not affect the achievement of sustained virological response. Journal of Viral Hepatitis, 15(4), pp. 300-4. doi:10.1111/j.1365-2893.2007.00944.x.
Napoli N, et al. The Use of Different Peg-interferon Alpha-2b Regimens Plus Ribavirin in HCV-1b-infected Patients After Rapid Virological Response Does Not Affect the Achievement of Sustained Virological Response. J Viral Hepat. 2008;15(4):300-4. PubMed PMID: 18307592.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The use of different Peg-interferon alpha-2b regimens plus ribavirin in HCV-1b-infected patients after rapid virological response does not affect the achievement of sustained virological response. AU - Napoli,N, AU - Giannelli,G, AU - Antonaci,A, AU - Antonaci,S, PY - 2008/3/1/pubmed PY - 2008/3/21/medline PY - 2008/3/1/entrez SP - 300 EP - 4 JF - Journal of viral hepatitis JO - J. Viral Hepat. VL - 15 IS - 4 N2 - In patients with chronic hepatitis C, rapid virological response (RVR) at week 4 of treatment seems to be strongly associated with a high probability of achieving a sustained virological response (SVR). The aim of this study was to investigate the outcome of different pegylated interferon-alpha2b (Peg-IFN-alpha2b) dosages plus ribavirin (RBV) in patients with RVR. Forty-five naïve patients chronically infected with hepatitis C virus (HCV)-1b started Peg-IFN-alpha2b (1.5 microg/kg/week) in combination with weight-based RBV doses (800-1200 mg/day). Thirty-one patients (68.9%) attained RVR at week 4 of therapy, while four further patients showed negative HCV-RNA values for the first time at week 12 and were considered early virological responders (EVR). The 31 RVR patients were randomized to receive either RBV plus 1.5 microg/kg/week (17 pts) or 1.0 microg/kg/week (14 pts) of Peg-IFN-alpha2b for the remaining 44 weeks. The two groups were matched for age, sex, baseline alanine aminotransferase levels, viral load and fibrosis score. After 6 months of post-treatment follow-up, the prevalence of SVR was 94.1% (16/17) among RVR patients treated with 1.5 microg/kg/week and 92.8% (13/14) in RVR patients treated with 1.0 microg/kg/week (P = not significant). A high-baseline viral load (P = 0.01) and bridging fibrosis/cirrhosis (P = 0.02) negatively influenced the likelihood of achieving RVR. On the contrary, the ability of RVR patients to achieve SVR did not correlate with these baseline characteristics in either of the treatment group. Finally, the SVR rate among EVR patients who responded after more than 4 weeks of treatment was significantly lower than among RVR patients (1/4 = 25%vs 29/31 = 93.5%; P = 0.0058), because of a high prevalence of post-treatment relapse among patients with EVR. SN - 1365-2893 UR - https://www.unboundmedicine.com/medline/citation/18307592/The_use_of_different_Peg_interferon_alpha_2b_regimens_plus_ribavirin_in_HCV_1b_infected_patients_after_rapid_virological_response_does_not_affect_the_achievement_of_sustained_virological_response_ L2 - https://doi.org/10.1111/j.1365-2893.2007.00944.x DB - PRIME DP - Unbound Medicine ER -