Efficacy of combination treatment with pegylated interferon plus ribavirin in patients chronically infected with HCV
Authors:
P. Urbánek 1; I. Subhanová 2; E. Janoušová 3; L. Dušek 3; Z. Mareček 1; R. Brůha 4; J. Petrtýl 4; M. Brodanová 5
Authors‘ workplace:
Interní klinika 1. lékařské fakulty UK a ÚVN Praha, přednosta pplk. prof. MUDr. Miroslav Zavoral, Ph. D.
1; Ústav klinické biochemie a laboratorní diagnostiky 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Tomáš Zima, DrSc., MBA
2; Institut biostatistiky a analýz Lékařské fakulty MU Brno, přednosta doc. RNDr. Ladislav Dušek, Ph. D.
3; IV. interní klinika 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Aleš Žák, DrSc.
4; I. interní klinika hematoonkologie 1. lékařské fakulty UK a VFN Praha, přednosta doc. MUDr. Marek Trněný, CSc.
5
Published in:
Vnitř Lék 2009; 55(5): 474-479
Category:
Original Contributions
Overview
The aim of the study:
To evaluate the efficacy of combined antiviral treatment with pegylated interferon α plus ribavirin in patients with chronic HCV infection who have not yet been treated with antivirals (treatment-naive patients). To compare the treatment effect in patients with low (< 600,000 IU/ml) and high (≥ 600,000 IU/ml) initial viremia.
Methods and treatment regime:
Treatment-naive patients with chronic HCV infection treated with the combination therapy of pegylated interferon-α2a plus ribavirin. Treatment response was evaluated at weeks 12, 24 and 48 when treatment was ongoing and at weeks 12, 24 and 48 after the treatment was finished. Commercially available sets from various manufacturers were used for serum and molecular genetic diagnostics of HCV infection.
Patient sample:
Antiviral treatment was initiated in 175 patients between 2001 and 2007. The complete data sets suitable for statistical analysis were available for 143 patients. End of treatment response and sustained viral response analyses were conducted separately for HCV genotype 1 (n = 124) and genotype 2 + 3 (n = 7).
Results:
In the genotype 1 group, 76% of patients achieved end of treatment response and 59% of patients achieved sustained viral response. Both types of response were observed in 100% of the genotype 2 and 3 infected patients. When a correlation between initial viremia and sustained viral response was analysed, no statistically significant difference was observed between patients with low (< 600,000 IU/ml) and high (≥ 600 000 IU/ml) initial viremia.
Conclusion:
The results observed in the present study are generally slightly better than comparable results from large registration studies. In contrary to the published literature, the threshold of 600,000 IU/ml for initial viremia did not correlate statistically significantly with SVR.
Key words:
hepatitis C – pegylated interferon – ribavirin
Sources
1. World Health Organization. Hepatitis C. World Health Organization: 13. dostupné z: http://www.who.int/ mediacentre/factsheets/fs164/en.
2. Němeček V. Sérologický přehled ČR v roce 2001 – virová hepatitida A, B, C. Zprávy CEM 003 12 (příloha 1): 55–61.
3. Strader DB, Wright T, Thomas DL et al. Diagnosis, management and treatment of hepatitis C. AASLD Practice Guideline. Hepatology 2004; 39: 1147–1171.
4. Urbánek P, Husa P, Galský J et al. Standardní diagnostický a terapeutický postup chronické infekce virem hepatitidy C (HCV). Čas Lék Čes 2008; 147: příloha 12 stran.
5. Fried MW, Shiffman ML, Reddy KR et al. Peginterferon alfa‑2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 2002; 347: 975–982.
6. Hadziyannis SJ, Sette H, Morgan TR et al. Peginterferon‑alfa2a and ribavirin combination therapy in chronic hepatitis C. Ann Intern Med 2004; 140: 346–355.
7. Zeuzem S, Buti M, Ferenci P et al. Efficacy of 24 weeks treatment with peginterferon alfa‑2b plus ribavirin in patients with chronic hepatitis C infected with genotype 1 and low pretreatment viremia. J Hepatol 2006; 4: 97–103.
8. Husa P, Šlesinger P, Štroblová H et al. Závislost účinnosti léčby chronické hepatitidy C pegylovaným interferonem -2a a ribavirinem na vstupních parametrech a virové kinetice v počátcích léčby. Klin Mikrobiol Inf Lék 2008; 14: 65–71.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
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