Nowadays, interferon alfa-2b is still in widespread use for the treatment of chronic hepatitis C in China. In this study, peginterferon alfa-2a plus ribavirin was compared with interferon alfa-2b plus ribavirin for the initial treatment of genotype 1 chronic hepatitis C.
Overall, 168 patients with genotype 1 chronic hepatitis C were assigned peginterferon alfa-2a (135-180 µg subcutaneously/week) plus ribavirin (800-1200 mg/day orally) or interferon alfa-2b (300-500 million units, once every other day) plus ribavirin (800-1200 mg/day). According to HCV RNA levels at weeks 4 and 12, patients were reallocated to receive different interferon dosage forms or different courses of treatment. The primary endpoint was a sustained virological response (SVR).
A total of 160 patients completed the entire study and eight cases were lost to follow-up. The SVR rates in patients treated with peginterferon alfa-2a plus ribavirin for 24 and 48 weeks were 67.9% (53/78) and 73.6% (14/19), respectively, whereas in patients treated with interferon alfa-2b plus ribavirin for 24 and 48 weeks the SVR rates were 52.4% (43/82) and 40% (8/20), respectively. The SVR rates in the groups with a rapid virological response (RVR) and without RVR were 68.8 and 16.9%, respectively. The SVR rates in the groups with an early virological response (EVR) and in the groups without EVR were 88.1 and 10.5%, respectively.
Peginterferon alfa-2a plus ribavirin was more effective than interferon alfa-2b plus ribavirin, with similar safety. RVR can predict a greater chance of SVR. The duration of treatment should be shortened for patients with RVR. Treatment for patients without EVR should be discontinued.