Favorable factors for re-treatment with pegylated interferon α2a plus ribavirin in patients with high viral loads of genotype 1 hepatitis C virus

Authors: Tamori, Akihiro¹; Kioka, Kiyohide²; Kurai, Osamu³; Sakaguchi, Hiroki⁴; Enomoto, Masaru¹; Fujii, Hideki¹; Kobayashi, Sawako¹; Iwai, Shuji¹; Morikawa, Hiroyasu¹; Yamaguchi, Seiko³; Kawasaki, Yasuko²; Oka, Hiroko³; Tanaka, Yasuhito⁵; Kawada, Norifumi¹

Source: Hepatology Research, Volume 41, Number 12, 1 December 2011 , pp. 1169-1177(9)

Publisher: Wiley-Blackwell

Abstract:

Aim: Effect of re-treatment for pegylated interferon (PEG-IFN) plus ribavirin was not fully evaluated. We examined the effects of re-treatment with PEG-IFN plus ribavirin in patients with high viral loads of genotype 1 hepatitis C virus who failed to achieve a sustained virological response (SVR) with combination therapy.

Methods: We examined 38 patients who were re-treated with PEG-IFN α2a plus ribavirin for more than 60 weeks, among whom 14 were non-responders and 24 were relapsers after previous treatment with PEG-IFN α2b plus ribavirin. IL28B genotyping was done in 21 patients.

Results: The overall SVR rate was 34%. Analysis of baseline characteristics showed that the relapsers had a significantly higher SVR rate than the non-responders (50.0%, 12/24 vs. 7.1%, 1/14, respectively, P = 0.012) The SVR rates of re-treated patients who had turned hepatitis C virus (HCV) RNA-negative at weeks 8, 12, 24, and 48 of the previous therapy were 67% (4/6), 67% (4/6), 29% (2/7), and 25% (1/4), respectively. Re-treatment achieved an SVR in five of 12 patients with IL28B major alleles and three of nine patients with IL28B minor alleles. During the re-treatment, patients with complete viral suppression at week-12 achieved a significantly higher SVR rate (P = 0.001).

Conclusions: Re-treatment with PEG-IFN α2a plus ribavirin therapy is effective in patients who relapse after a course of PEG-IFN α2b plus ribavirin therapy. Re-treatment is a particularly useful option for patients who achieve early viral clearance during previous therapy.

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1872-034X.2011.00887.x

Affiliations:1: Department of Hepatology, Osaka City University Graduate School of Medicine2: Department of Hepatology Osaka City General Hospital3: Department of Gastroenterology and Hepatology, Osaka City Juso Hospital, Osaka4: Internal Medicine, Izumi Municipal Hospital, Izumi5: Department of Virology & Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

Publication date: 2011-12-01

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