16-week
Treatment May Be Adequate for Genotype 2 Hepatitis C Patients Current
hepatitis C virus (HCV) treatment guidelines call for 48 weeks of pegylated
interferon plus ribavirin for patients with hard-to-treat genotype
1 HCV, and 24 weeks for those with genotypes
2 or 3. However, for genotype 2 patients, a shorter course of therapy may
be sufficient, and would reduce the duration of side effects and the cost of treatment. As
reported in the September 6, 2006 electronic edition of Gut, researchers
from Taiwan assessed whether a 16-week course of treatment would be as effective
as the standard 24-week course. In their study, 150 genotype 2 patients were randomly
assigned to receive either 16 weeks (n = 50) or 24 weeks (n = 100) treatment with
180 mcg/week pegylated interferon alfa-2a
(Pegasys) plus 1000-1200 mg/day ribavirin. Results 
86% of patients in the 16-week arm experienced rapid virological response (RVR),
defined as undetectable HCV RNA 4 weeks into treatment, compared with 87% in the
24-week arm.
24 weeks after the completion of therapy, 94% of patients in the 16-week arm and
95% in the 24-week arm achieved sustained virological response (SVR).
Patients who experienced RVR were significantly more likely to achieve SVR in
both the 16-week arm (100% vs 57%; P = 0.015) and the 24-week arm (98% vs 77%;
P = 0.002).
Multivariate analysis showed that RVR and age were independent predictors of SVR.
Overall,
treatment was equally well tolerated in both arms.
However, alopecia (hair loss) was significantly more common in the 24-week arm
compared with the 16-week arm (49% vs 20%; P = 0.001).
Conclusion In
conclusion, the authors wrote, "16-week[s] and 24-week[s] of peginterferon
with ribavirin at a dose of 1000-1200 mg/day provided equal efficacy in HCV [genotype
2] patients who achieved a RVR at 4 weeks." 09/29/06 Reference
M
L Yu, C Y Dai, J F Huang, and others. A randomized study of peginterferon and
ribavirin for 16 vs 24 weeks in patients with genotype 2 chronic hepatitis C.
Gut. September 6, 2006 [Epub ahead of print].
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