Simeprevir-Based Triple Therapy with Reduced Doses of Pegylated Interferon α-2a Plus Ribavirin for Interferon Ineligible Patients with Genotype 1b Hepatitis C Virus.
- Author:
Hideyuki TAMAI
1
;
Yoshiyuki IDA
;
Akira KAWASHIMA
;
Naoki SHINGAKI
;
Ryo SHIMIZU
;
Kosaku MORIBATA
;
Tetsushi NASU
;
Takao MAEKITA
;
Mikitaka IGUCHI
;
Jun KATO
;
Taisei NAKAO
;
Masayuki KITANO
Author Information
- Publication Type:Original Article
- Keywords: Hepacivirus; Pegylated interferon; Ribavirin; Simeprevir; Interleukin-28B
- MeSH: Aged; Genotype*; Hepacivirus*; Hepatitis C*; Hepatitis*; Humans; Interferons*; Multivariate Analysis; Ribavirin*; RNA; Simeprevir; Transferases
- From:Gut and Liver 2017;11(4):551-558
- CountryRepublic of Korea
- Language:English
- Abstract: 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-α 2a (90 μg), 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 γ-glutamyl transferase and α-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.
