KMID : 1188320170110040551
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Gut and Liver 2017 Volume.11 No. 4 p.551 ~ p.558
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Simeprevir-Based Triple Therapy with Reduced Doses of Pegylated Interferon ¥á-2a Plus Ribavirin for Interferon Ineligible Patients with Genotype 1b Hepatitis C Virus
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Tamai Hideyuki
Ida Yoshiyuki Kawashima Akira Shingaki Naoki Shimizu Ryo Moribata Kosaku Nasu Tetsushi Maekita Takao Iguchi Mikitaka Kato Jun Nakao Taisei Kitano Masayuki
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Abstract
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Background/Aims: The present study aimed to evaluate the safety and efficacy of simeprevir-based triple therapy with reduced doses of pegylated interferon (PEG-IFN) and ribavirin for interferon (IFN) ineligible patients, such as elderly and/or cirrhotic patients, and to elucidate the factors contributing to a sustained virologic response (SVR).
Methods: One hundred IFN ineligible patients infected with genotype 1b hepatitis C virus (HCV) were treated. Simeprevir (100 mg) was given orally together with reduced doses of PEG-IFN-¥á 2a (90 ¥ìg), and ribavirin (200 mg less than the recommended dose).
Results: The patients¡¯ median age was 70 years, and 70 patients were cirrhotic. Three patients (3%) discontinued treatment due to adverse events. The SVR rate was 64%. Factors that significantly contributed to the SVR included the ¥ã-glutamyl transferase and ¥á-fetoprotein levels, interleukin-28B (IL28B) polymorphism status, and the level and reduction of HCV RNA at weeks 2 and 4. The multivariate analysis showed that the IL28B polymorphism status was the only independent factor that predicted the SVR, with a positive predictive value of 77%.
Conclusions: Simeprevir-based triple therapy with reduced doses of PEG-IFN and ribavirin was safe and effective for IFN ineligible patients infected with genotype 1b HCV. IL28B polymorphism status was a useful predictor of the SVR.
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KEYWORD
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Hepacivirus, Pegylated interferon, Ribavirin, Simeprevir, Interleukin-28B
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