Duration of
Peginterferon Therapy in Acute Hepatitis C
Spontaneous resolution of acute hepatitis C virus
infection cannot be predicted, and chronic evolution of the disease occurs in
a majority of cases. To assess the efficacy and safety of peginterferon
alfa-2b (PegIntron) administered for 8, 12, or 24 weeks in patients with acute
hepatitis C virus infection, a total of 161 patients were identified with acute
hepatitis C virus infection.
Results
Of these 161 patients, 30 refused treatment but
were retained in the study as a nonrandomized comparison group.
Of the 131 patients who consented to treatment,
29 patients spontaneously resolved, leaving 102 patients randomly assigned to
peginterferon alfa-2b (1.5 microgram/kg) for 8 weeks
(group A; n = 34), 12 weeks (group B; n = 34), and 24 weeks (group C; n = 34).
The primary end point was sustained
virologic response.
An intent-to-treat analysis was used for efficacy
and safety end points.
Sustained virologic response was achieved in 23/34 (67.6%), 28/34 (82.4%),
and 31/34 (91.2%) of patients in groups A, B, and C, respectively.
All had undetectable hepatitis
C virus RNA 48 weeks after the end of therapy.
Treatment for 8 or 12 weeks was effective in genotypes
2, 3, and 4,
whereas genotype
1 required 24 weeks of therapy.
The 8- and 12-week regimens were associated with
fewer adverse events compared with the 24-week regimen. |
In
conclusion, the authors write, “Peginterferon alfa-2b
effectively induces high sustained virologic response
rates in patients with acute hepatitis C virus infection, thus preventing development
of chronic hepatitis C.” “Duration
of treatment should be further optimized based on genotype and rapid
virologic response at week 4. 05/09/06 Reference
S
M Kamal, K N Moustafa, J Chen, and
others.
Duration of peginterferon therapy in acute hepatitis
C: A randomized trial. Hepatology 43(5): 923-931. May 2006.
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