Assessment of the Efficacy of Reducing Peginterferon Alfa-2a and Ribavirin Dose on Virologic Response in Koreans with Chronic Hepatitis C.
10.3904/kjim.2009.24.3.203
- Author:
Jung Hyun KWON
1
;
Si Hyun BAE
;
Jong Young CHOI
;
Seung Kew YOON
;
Kwan Soo BYUN
;
Seung Woon PAIK
;
Young Suk LIM
;
Han Chu LEE
;
Kwang Hyub HAN
;
Kwan Sik LEE
Author Information
1. Department of Internal Medicine, WHO Collaborating Center on Viral Hepatitis, The Catholic University of Korea College of Medicine, Seoul, Korea. baesh@catholic.ac.kr
- Publication Type:Original Article ; Multicenter Study
- Keywords:
Peginterferon alfa-2a;
Ribavirin;
Hepatitis C;
Koreans
- MeSH:
Adult;
Aged;
Antiviral Agents/*administration & dosage;
Drug Therapy, Combination;
Female;
Hepatitis C, Chronic/*drug therapy/virology;
Humans;
Interferon Alfa-2a/*administration & dosage/adverse effects;
Male;
Middle Aged;
Polyethylene Glycols/*administration & dosage/adverse effects;
RNA, Viral/blood;
Ribavirin/*administration & dosage/adverse effects
- From:The Korean Journal of Internal Medicine
2009;24(3):203-211
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The virologic response of Koreans to combination therapy for chronic hepatitis C is similar to westerns; however, dose modification occurs more frequently in Koreans. We evaluated the rates of peginterferon alpha-2a and ribavirin dose modifications and their effect on the virologic response in Koreans. METHODS: Patients with detectable HCV RNA and enrolled from multicenters were treated with peginterferon alpha-2a (180 microgram/week) and ribavirin (800 mg/day) for 24 weeks (genotype non-1, n=37) or peginterferon alpha-2a (180 microgram/week) and ribavirin (1,000-1,200 mg/day) for 48 weeks (genotype 1, n=55). RESULTS: Early virologic response (EVR) and sustained virologic response (SVR) were 77.2% (genotype 1, 75%; non-1, 81%) and 66.3% (genotype 1, 56%; non-1, 81%), respectively. The frequency of dose modification was 32.6% within the first 12 weeks and 52.2% during the entire treatment period. No difference was found in SVR regardless of dose modification. However, the SVR for patients using > or =80% of the peginterferon dose was significantly higher than for those using <80% (81.3 vs. 50.0%, p=0.007), despite varying ribavirin doses. No difference was found in SVR regardless of whether the ribavirin dose was <80% or not. These results did not change based on genotype. CONCLUSIONS: We suggest that using at least 80% of the peginterferon alpha-2a dose in Koreans not only maintains SVR but also reduces drug side effects during the entire treatment period. A lower dose of ribavirin may be as efficacious as a standard dose.
