Peginterferon-α2a and ribavirin combination therapy in chronic hepatitis C. A randomized study of treatment duration and ribavirin dose


Hadziyannis, Stephanos J., Sette, Hoel, JrMorgan, Timothy R., Balan, Vijayan, Diago, Moises, Marcellin, Patrick, Ramadori, Giuliano, Bodenheimer, Henry, JrBernstein, David, Rizzetto, Mario, Zeuzem, Stefan, Pockros, Paul J., Lin, Amy and Ackrill, Andrew M. (2004) Peginterferon-α2a and ribavirin combination therapy in chronic hepatitis C. A randomized study of treatment duration and ribavirin dose. Annals of Internal Medicine, 140, (5), 346-355.

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Description/Abstract

BACKGROUND:
Treatment with pegylated interferon (peginterferon) and ribavirin for 48 weeks is more effective than conventional interferon and ribavirin in patients with chronic hepatitis C.

OBJECTIVE:
To assess the efficacy and safety of 24 or 48 weeks of treatment with peginterferon-alpha2a plus a low or standard dose of ribavirin.

DESIGN:
Randomized, double-blind trial.

SETTING:
99 international centers. PATIENTS: 1311 patients with chronic hepatitis C.

PATIENTS:
1311 patients with chronic hepatitis C.

INTERVENTION:
Peginterferon-α2a, 180 μ/wk, for 24 or 48 weeks plus a low-dose (800 mg/d) or standard weight-based dose (1000 or 1200 mg/d) of ribavirin. Measurement: Sustained virologic response: undetectable HCV RNA concentration at the end of treatment and during 12 to 24 weeks of follow-up.

RESULTS:
Overall and in patients infected with HCV genotype 1, 48 weeks of treatment was statistically superior to 24 weeks and standard-dose ribavirin was statistically superior to low-dose ribavirin. In patients with HCV genotype 1, absolute differences in sustained virologic response rates between 48 and 24 weeks of treatment were 11.2% (95% CI, 3.6% to 18.9%) and 11.9% (CI, 4.7% to 18.9%), respectively, between standard- and low-dose ribavirin. Sustained virologic response rates for peginterferon-alpha2a and standard-dose ribavirin for 48 weeks were 63% (CI, 59% to 68%) overall and 52% (CI, 46% to 58%) in patients with HCV genotype 1. In patients with HCV genotypes 2 or 3, the sustained virologic response rates in the 4 treatment groups were not statistically significantly different.

CONCLUSION:
Treatment with peginterferon-α2a and ribavirin may be individualized by genotype. Patients with HCV genotype 1 require treatment for 48 weeks and a standard dose of ribavirin; those with HCV genotypes 2 or 3 seem to be adequately treated with a low dose of ribavirin for 24 weeks.

Item Type: Article
Related URLs:
Subjects: R Medicine > RB Pathology
Q Science > QR Microbiology > QR355 Virology
R Medicine > RM Therapeutics. Pharmacology
Divisions: University Structure - Pre August 2011 > School of Medicine > Infection, Inflammation and Repair
ePrint ID: 27083
Date Deposited: 26 Apr 2006
Last Modified: 27 Mar 2014 18:15
URI: http://eprints.soton.ac.uk/id/eprint/27083

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