Peginterferon α-2b and ribavirin therapy in chronic hepatitis C genotype 4: impact of treatment duration and viral kinetics on sustained virological response

Kamal, S. M.; El Tawil, A. A.; Nakano, T.; He, Q.; Rasenack, J.; Hakam, S. A.; Saleh, W. A.; Ismail, A.; Aziz, A. A.; Madwar, M. Ali
June 2005
Gut;Jun2005, Vol. 54 Issue 6, p858
Academic Journal
Background: The response rates and duration of peginterferon alpha (PEG-IFN-α) and ribavirin combination therapy in chronic hepatitis C genotype 4, the prevalent genotype in the Middle East and Africa, are poorly documented. Aims: To compare the efficacy and safety of 24, 36, or 48 weeks of PEG-IFN-α-2b and ribavirin therapy in chronic hepatitis C genotype 4. Methods: In this prospective, randomised, double blind study, 287 patients with chronic hepatitis C genotype 4 were randomly assigned to PEG-IFN-α-2b (1.5 μg/kg) once weekly plus daily ribavirin (1000-1200 mg) for 24 weeks (group A, n=95), 36 weeks (group B, n=96), or 48 weeks (group C, n = 96) and followed for 48 weeks after completion of treatment. Early viral kinetics and histopathological evaluation of pre- and post treatment liver biopsies were performed. The primary end point was viral clearance 48 weeks after completion of treatment. Results: Sustained virological response was achieved in 29%, 66%, and 69% of patients treated with PEG- IFN-α-2b and ribavirin for 24, 36, and 48 weeks, respectively, by intention to treat analysis. No statistically significant difference in sustained virological response rates was detected between 36 and 48 weeks of therapy (p = 0.3). Subjects with sustained virological response showed greater antiviral efficacy (c) and rapid viral load decline from baseline to treatment week 4 compared with non-responders and improvement in liver histology. The incidence of adverse events was higher in the group treated for 48 weeks. Conclusion: PEG-IFN-α-2b and ribavirin for 36 or 48 weeks was more effective in the treatment of chronic hepatitis C genotype 4 than treatment for 24 weeks. Thirty six week therapy was well tolerated and produced sustained virological and histological response rates similar to the 48 week regimen.


Related Articles

  • Revisiting the Stopping Rule for Hepatitis C Genotype 1 Patients Treated with Peginterferon Plus Ribavirin. Yu, Ming-Lung; Liu, Chen-Hua; Huang, Chung-Feng; Tseng, Tai-Chung; Huang, Jee-Fu; Dai, Chia-Yen; Lin, Zu-Yau; Chen, Shinn-Cherng; Wang, Liang-Yen; Hank Juo, Suh-Hang; Chuang, Wan-Long; Kao, Jia-Horng // PLoS ONE;Dec2012, Vol. 7 Issue 12, p1 

    Background: The current stopping rule for peginterferon/ribavirin therapy in hepatitis C virus genotype-1 (HCV-1) patients is based on an early virological response (EVR, defined as >2 log10 viral reduction at treatment week 12). We aimed to explore rapid stopping rules at week 4. Methods: We...

  • Monitoring ribavirin concentration predicts early response, anaemia.  // Reactions Weekly;9/10/2005, Issue 1068, p3 

    Discusses research being done on the importance of ribavirin monitoring concentration in predicting hepatitis C virus (HCV). Reference to a study by A. L. Rendón published in the August 2005 issue of the "Journal of Acquired Immune Deficiency Syndromes"; Mean plasma ribavirin concentrations...

  • Ribavirin.  // Encyclopedic Reference of Cancer;2001, p804 

    An encyclopedia entry for ribavirin is presented. Ribavirin is defined as a synthetic 1-beta-D-ribofuranosyl-1H-1,2,4-triazole-3-carboxamide. It is used against hepatitis C virus.

  • Treatment of anicteric acute hepatitis C with peginterferon alpha-2a plus ribavirin. Delić, Dragan; Nešić, Zorica; Prostran, Milica; Simonović, Jasmina; Švirtlih, Neda // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;Nov2005, Vol. 62 Issue 11, p865 

    Background Hepatitis C virus (HCV) infection is the most frequent cause of chronic hepatitis, cirrhosis, and hepatocellular carcinoma in the world. Acute hepatitis C is the most commonly asymptomatic liver disease with the development of chronic HCV infection in the majority of infected...

  • Ribavirin concentration in the later stages of 48 week pegylated interferon-α2b plus ribavirin therapy for chronic hepatitis C is useful for predicting virological response. Furusyo, Norihiro; Murata, Masayuki; Ogawa, Eiichi; Toyoda, Kazuhiro; Ihara, Takeshi; Ikezaki, Hiroaki; Hayashi, Takeo; Koga, Tsunehisa; Kainuma, Mosaburo; Hayashi, Jun // Journal of Antimicrobial Chemotherapy (JAC);May2011, Vol. 66 Issue 5, p1127 

    Objectives The current standard of care for chronic hepatitis C patients is a pegylated interferon-α plus ribavirin combination treatment. This study was carried out to determine the relationship between ribavirin concentration in the later stages of treatment and virological relapse....

  • Access to Peginterferon plus Ribavirin Therapy for Hepatitis C in Romania between 2002-2009. Gheorghe, Liana; Pascu, Oliviu; Ceausu, Emanoil; Csiki, Irma Eva; Iacob, Speranta; Caruntu, Florin; Simionov, Iulia; Vadan, Roxana // Journal of Gastrointestinal & Liver Diseases;Jun2010, Vol. 19 Issue 2, p161 

    Background: An overall prevalence rate of HCV infection in Romanian adult population was recently estimated to be 3.23%. The proportion of treated patients with chronic hepatitis C in our country has never been assessed. Aims: 1) to analyze the quality and quantity of antiviral therapy delivery;...

  • Enhanced anti-HCV activity of interferon alpha 17 subtype. Dubois, Aurelie; François, Catherine; Descamps, Veronique; Fournier, Carole; Wychowski, Czeslaw; Dubuisson, Jean; Castelain, Sandrine; Duverlie, Gilles // Virology Journal;2009, Vol. 6, p1 

    Background: Pegylated interferon alpha 2 (a or b) plus ribavirin is the most effective treatment of chronic hepatitis C but a large proportion of patients do not respond to therapy. So, it is interesting to improve the treatment efficacy. Interferon alpha is a type I interferon composed of 12...

  • Peginterferon-α-2a (40kD) plus ribavirin: a new treatment option takes flight in chronic hepatitis C.  // Drugs & Therapy Perspectives;Feb2004, Vol. 20 Issue 2, p1 

    Combination therapy with peginterferon-α-2a (40kD) [Pegasys®] plus ribavirin (Copegus™, Rebetol®) is a valuable new option for the first-line treatment of chronic hepatitis C. With regard to the sustained virological response rate, peginterferon-α-2a (40kD) plus ribavirin...

  • Recent Successes and Noteworthy Future Prospects in the Treatment of Chronic Hepatitis C. Fox, Alyson N.; Jacobson, Ira M. // Clinical Infectious Diseases;Jul2012 Supplement 1, Vol. 55 Issue suppl_1, pS16 

    Within the last year, the landscape of therapy for genotype 1 chronic hepatitis C virus (HCV) has changed dramatically as 2 much-anticipated protease inhibitors became available for use. These agents, telaprevir and boceprevir, when used in combination with pegylated interferon and ribavirin,...


Read the Article


Sign out of this library

Other Topics