Efficacy
of Low-dose versus Standard Dose Pegylated Interferon Alfa-2b (PegIntron) plus
Ribavirin for Treatment of Chronic Hepatitis C with Severe Fibrosis
•
Overall, considering all genotypes, SVR was observed in 44.5% (45/101) of patients
treated with the standard dose of Peg-IFN and 37.2% (38/102) of patients treated
with the low dose (NS).
•
In patients with genotypes 1, 4 and
5, SVR was observed in 25.0% of patients who received the standard dose and
16.9% of patients who received the low dose of Peg-IFN (P = NS).
•
In patients with genotypes 1, 4 and 5 and low viremia, SVR was obtained in 27.3%
of patients treated with the standard dose and 25.8% of patients treated with
the low dose (P = NS).
•
In the high-viremia subgroup, SVR was obtained in 24.0% and 9.1% of patients,
respectively.
• In
patients with genotypes 2 and 3,
SVR was similar in both groups (73.2%vs 73.0%).
Based
on the findings, the authors conclude the following:
(1)
Patients with genotypes 2 and 3 and severe fibrosis can be treated with low dose
of Peg-IFN and ribavirin., (2) This
study suggests that patients with genotypes 1, 4 and 5 and high viremia could
receive a standard dose of Peg-IFN associated with ribavirin for 48 weeks. (3)
Side effects limit the efficacy of the treatment with standard dose of Peg-IFN
in patients with genotypes 1, 4 and 5 and low viremia. (4)
More studies are needed for patients with genotype 2 or 3 to define the optimal
duration (24 or 48 weeks) in patients with severe fibrosis.
1/19/07
Reference A
Abergel, C Hezode, V Leroy, and others. Peginterferon alpha-2b plus ribavirin
for treatment of chronic hepatitis C with severe fibrosis: a multicentre randomized
controlled trial comparing two doses of peginterferon alpha-2b. Journal of
Viral Hepatitis 13(12): 811-820. December 2006.
