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KMID : 1103920090150040496
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Korean Journal of Hepatology
2009 Volume.15 No. 4 p.496 ~ p.503
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A comparison of 24- vs. 48-week peginterferon plus ribavirin in patients with genotype 1 chronic hepatitis C
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Kim Mi-Na
Yoon Ki-Tae
Park Jun-Yong
Kim Do-Young
Ahn Sang-Hoon
Chon Chae-Yoon
Han Kwang-Hyub
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Abstract
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Background/Aims: The standard therapy for patients with genotype 1 chronic hepatitis C (CHC) is a combination of peginterferon and ribavirin for 48 weeks. However, the most appropriate duration of treatment remains to be established because of treatment-related side effects and cost. The aim of this study was to compare the efficacies of 24- and 48-week treatments, and to assess the efficacy of split 24-week therapy (a further 24 weeks of treatment in patients with relapse after the initial 24 weeks of treatment).
Methods: A total of 130 patients with genotype 1 CHC was treated between June 2004 and December 2006. Patients with undetectable HCV RNA at 24 weeks of treatment (as assessed by qualitative PCR assay; n=101 patients) were allowed to choose either 24 or 48 weeks as the duration of their treatment; 51 patients chose the 24-week treatment regimen and the remainder chose the 48-week regimen. Patients who relapsed after 24 weeks of treatment were treated for further 24 weeks. The sustained virologic response (SVR) of each treatment group was analyzed.
Results: The SVR rate was higher in patients treated for 48 weeks than in those treated for 24 weeks (74.0% vs. 52.9%, P=0.028). In the multivariate analysis, age < 50 years, platelets ≥ 150,000/mm3, and treatment duration for 48 weeks remained significant independent predictors of SVR. Fourteen of the 24 patients who relapsed in the 24-week treatment group received split 24-week therapy, and 6 patients (42.9%) achieved SVR. The overall SVR rate did not differ significantly between the 24-week treatment group, including those who underwent 24-week split therapy (64.7%), and the 48-week treatment group (64.7% vs. 74%, P=0.311).
Conclusions: The 24-week plus additional split 24-week therapy following failure is a useful treatment strategy for patients with genotype 1 CHC.
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KEYWORD
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Chronic hepatitis C, Genotype 1, Peginterferon, Ribavirin
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