An early viral response to standard interferon-alpha identifies resistance to combination therapy with peginterferon and ribavirin in patients infected by HCV genotype 1

Journal of Medical Virology
Volume 82 Issue 9, Pages 1537 - 1544
Published Online: 15 Jul 2010
Copyright © 2010 Wiley-Liss, Inc., A Wiley Company

Hidenori Toyoda *, Takashi Kumada, Seiki Kiriyama, Makoto Tanikawa, Yasuhiro Hisanaga, Akira Kanamori, Toshifumi Tada, Makiko Takagi, Takeshi Hiramatsu, Takanori Hosokawa, Takahiro Arakawa, Masashi Fujimori

Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
email: Hidenori Toyoda (hmtoyoda@spice.och.ne.jp)

*Correspondence to Hidenori Toyoda, Department of Gastroenterology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu 503-8502, Japan.

Keywords
chronic hepatitis C • standard interferon • peginterferon and ribavirin • non-response • resistance to interferon

Abstract

As combination therapy with peginterferon (PEG-IFN) and ribavirin has a high morbidity, identifying individuals with hepatitis C virus (HCV) who will not respond to the treatment would be beneficial. The early responses of serum HCV RNA levels to standard interferon (IFN) and PEG-IFN were examined to determine if it was possible to identify resistance to combination therapy. One hundred thirty-one patients infected with HCV genotype 1b were enrolled. Patients were given 6 MU of standard IFN alpha-2b at least 2 weeks before initiating combination therapy. Serum HCV RNA levels were measured before, 24 hr after the administration of standard IFN, and 24 hr after the administration of PEG-IFN (at the start of the combination therapy). The association between reductions in HCV RNA levels at 24 hr after the administration of standard IFN and PEG-IFN and the outcome of combination therapy were analyzed. Reductions in HCV RNA levels were poorer in patients who did not respond than in those with a sustained virologic responses or relapses (P < 0.0001), both 24 hr after the administration of standard IFN and 24 hr after the administration of PEG-IFN. Reductions in HCV RNA levels 24 hr after the administration of standard IFN were an independent factor associated with non-response by multivariate analysis. An early reduction in viral load to a single administration of standard IFN is a useful predictor of non-response in patients with HCV genotype 1, allowing for pretreatment identification of patients who will not benefit from combination therapy. J. Med. Virol. 82:1537-1544, 2010. © 2010 Wiley-Liss, Inc.

Accepted: 20 April 2010

Digital Object Identifier (DOI)
10.1002/jmv.21858 About DOI

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