Studies Explore Lower Doses of Pegylated Interferon and Ribavirin for People with
Hepatitis C Virus Genotypes 2 or 3
•
70% of genotype 2 patients and 71% with genotype 3 achieved rapid viral response
(RVR), or HIV RNA < 15 IU/mL at week 4 of treatment.
•
Overall, 85% of genotype 2 patients and 86% with genotype 3 went on to achieve
SVR.
•
Significantly more genotype 2 patients with RVR achieved SVR (96%) compared with
genotype 2 patients who failed to achieve RVR (66%) (P = 0.009).
•
For patients with genotype 3, the corresponding SVR rates were 95% with RVR and
65% without RVR (P = 0.002).
"We
found that 135 mcg [pegylated interferon] alfa-2a weekly was sufficient for treatment
of genotype 2 and 3 chronic hepatitis C when combined with ribavirin dosed daily
according to body weight," the investigators concluded. "This combination
yielded high SVR rates (85-86%) and may be cost-saving."
Low-dose
Ribavirin In
a related analysis, the Australia Hepatitis Study Group assessed the efficacy
and tolerability of ribavirin administered at half the standard dose for patients
with HCV genotype 2 or 3. Results were reported in the June 2008 issue of Hepatology.
This
study included 282 treatment-naive genotype 2 or 3 chronic hepatitis C patients
randomly assigned to receive either 400 mg/day or 800 mg/day fixed-dose ribavirin
in combination with 180 mcg/week pegylated interferon alfa-2a for 24 weeks.
Results
•
Overall, 97 of 141 patients (68.8%) using the standard ribavirin dose achieved
SVR, compared with 90 of 141 patients (63.8) using the lower dose.
•
Relapse rates in the standard-dose and low-dose groups were similar, at 17% vs
20%, respectively.
•
Among genotype 3 patients, the standard-dose and low-dose SVR rates were 67.5%
and 63.9%, respectively.
•
Among genotype 2 patients, the corresponding SVR rates were more divergent, at
77.8% and 55.6%, respectively.
•
The incidence of adverse events, laboratory abnormalities, and dose reductions
were similar in the 2 ribavirin dose groups.
Based
on these findings, the authors concluded, "The results suggest that when
administered for 24 weeks with peginterferon alfa-2a, ribavirin doses of 400 and
800 mg/day produce equivalent outcomes in patients infected with HCV genotype
3."
7/08/08
References O
Weiland, A Hollander, L Mattsson, and others. Lower-than-standard dose peg-IFN
alfa-2a for chronic hepatitis C caused by genotype 2 and 3 is sufficient when
given in combination with weight-based ribavirin. Journal of Viral Hepatitis.
May 27, 2008 [Epub ahead of print].  P
Ferenci, H Brunner, H Laferl, and other (for the Australia Hepatitis Study Group).
A randomized, prospective trial of ribavirin 400 mg/day versus 800 mg/day in combination
with peginterferon alfa-2a in hepatitis C virus genotypes 2 and 3. Hepatology
47(6): 1816-1823. June 2008. Abstract
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