Several recent studies have shown that rapid virological
response (RVR) to hepatitis C treatment with pegylated
interferon plus ribavirin - or undetectable HCV RNA after 4 weeks of therapy
- is a good predictor of sustained virological response (SVR) 6 months after completion
of treatment.
In a study described in the current issue of the Journal
of Viral Hepatitis (April 2008), Italian researchers investigated whether
different dosages of pegylated interferon plus ribavirin would influence the likelihood
of achieving SVR in patients who had already achieved RVR.
The
31 rapid responders were then randomly assigned to continue on either 1.5 mcg/kg/week
(n=17) or 1.0 mcg/kg/week (n=14) PegIntron plus the same dose of ribavirin for
the remaining 44 weeks. The 2 groups were well matched for age, sex, baseline
alanine aminotransferase (ALT) levels, HCV viral load, and fibrosis scores.
Results
•
After 6 months of post-treatment follow-up, 16 of 17 RVR patients (94.1%) in the
PegIntron 1.5 mcg/kg/week arm had achieved SVR, compared with 13 of 14 (92.8%)
in the 1.0 mcg/kg/week (a non-significant difference).
•
High baseline HCV RNA (P = 0.01) and pre-existing bridging fibrosis
or cirrhosis (P = 0.02) were associated
with a lower likelihood of achieving RVR.
•
However, the ability of rapid responders to achieve SVR did not correlate with
these baseline characteristics in either PegIntron dose group.
•
The SVR rate among EVR patients who responded after more than 4 but up to 12 weeks
of treatment was significantly lower than that observed for RVR patients (25.0%
vs 93.5%; P = 0.0058)
Conclusion
Based
on these findings, the researchers concluded that varying the dose of pegylated
interferon did not affect the likelihood of achieving sustained virological response.
They
attributed the difference in sustained response rates to a higher prevalence of
post-treatment relapse among patients with early (12 week) but not rapid (4 week)
virological response.
3/18/08
Reference N
Napoli, G Giannelli, A Antonaci, and others. The use of different Peg-interferon
alpha-2b regimens plus ribavirin in HCV-1b-infected patients after rapid virological
response does not affect the achievement of sustained virological response. Journal
of Viral Hepatitis 15(4): 300-304. April 2008.
Results
