24 Weeks Treatment with Pegylated Interferon Alfa Plus Ribavirin May Be Possible in Genotype 1 Chronic Hepatitis C Patients with Rapid Virological Response Who Have Low Pretreatment Viremia

Sung Soo Moon; Hyoun Gu Kang; Jeong Ah Seo; Eun Uk Jung; Sang Heon Lee; Sung Jae Park; Youn Jae Lee; Sang Yong Seol

doi:10.4166/kjg.2010.56.1.33

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Moon, Kang, Seo, Jung, Lee, Park, Lee, and Seol: 24 Weeks Treatment with Pegylated Interferon Alfa Plus Ribavirin May Be Possible in Genotype 1 Chronic Hepatitis C Patients with Rapid Virological Response Who Have Low Pretreatment Viremia

Original Article

Korean J Gastroenterol 2010;56(1):33-38.

Published online: 21 February 2010

DOI: https://doi.org/10.4166/kjg.2010.56.1.33

24 Weeks Treatment with Pegylated Interferon Alfa Plus Ribavirin May Be Possible in Genotype 1 Chronic Hepatitis C Patients with Rapid Virological Response Who Have Low Pretreatment Viremia

Sung Soo Moon, M.D., Hyoun Gu Kang, M.D., Jeong Ah Seo, M.D., Eun Uk Jung, M.D., Sang Heon Lee, M.D., Sung Jae Park, M.D., Youn Jae Lee, M.D., Sang Yong Seol, M.D.

Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea

Correspondence to: Youn Jae Lee, M.D. Department of Internal Medicine, Inje University College of Medicine, Paik Hospital, 633-165, Gaegeum-dong, Jin-gu, Busan 614-735, Korea Tel: +82-51-890-6270, Fax: +82-51-892-0273 E-mail: yjyh0105@dreamwiz.com

Received 13 January 2010 Accepted 19 April 2010

Abstract

Background/Aims

The standard treatment for chronic hepatitis C infected with hepatitis C virus (HCV) genotype 1 is a combination of pegylated interferon alfa and ribavirin over a 48 weeks period. It is unclear if 24 weeks treatment is possible for patients showing a rapid virological response (RVR) without compromising the sustained virological response (SVR) in Korea.

Methods

Between June 2005 and September 2008, among patients chroni-cally infected with the HCV genotype 1 who were treated with pegylated interferon alfa subcutaneously once weekly plus ribavirin based on body weight, 55 patients who had low pretreatment viral load (＜600,000 IU/mL) and RVR were enrolled. A total of 55 patients were divided into 24 weeks treatment group (n=29) and the standard treatment group (n=26). The HCV RNA was quantitatively assessed before treatment, and after 12 weeks of treatment, and also qualitatively assessed after 4 weeks of treatment, at end of treatment (24 weeks), and 24 weeks after end of treatment. RVR was defined as undetectable HCV RNA at the 4 weeks of treatment.

Results

Among the 55 patients, SVR was achieved in 100% (29/29) of the patients in 24 weeks treatment and 96.2% (25/26) of the patients in the standard treatment (p=0.473).

Conclusions

HCV genotype 1 infected patients with a low baseline HCV RNA concentration who become HCV RNA negative at week 4 may be treated for 24 weeks without compromising sustained virlolgical response. However, an additional trial will be needed to opti-mize the treatment duration.

Keywords: Hepatitis C, Short term treatment, Rapid virological response, Pegylated interferon, Ribavirin

REFERENCES

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Table 1.

Baseline Characteristics and Virologic Response of the Enrolled Patients

	Standard treatment	24 weeks treatment	p-value
Patients (N)	26	29
Age	45.77±10.73	46.24±11.54	0.876^†
Sex (M/F)	12/14	21/8	0.047^‡
BMI	23.5±2.54	23.8±2.26	0.573^†
Pretx. HCV RNA (IU/mL)	1.935×10⁵^∗ (1.0×10⁴-5.967×10⁵)	1.31×10⁵^∗ (3.4×10³-4.976×10⁵)	0.102^§
AST (U/mL)	67.58±35.78	64±46.1	0.748^†
ALT (U/mL)	103.62±69.55	99.34±132.3	0.88^†
SVR	25/26	29/29	0.473^‡

BMI, body mass index; HCV RNA, hepatitis C virus RNA; AST, aspartate aminotransferase; ALT, alanine aminotransferase; SVR, sustained virological response.

^∗ Median.

^† Student t-test.

^‡ Chi-square test.

^§ Mann-Whitney test.

Table 2.

Baseline Characteristics and Virological Response of 24 Weeks Treatment Patients

	Sex	Age	BW (kg)	Height (cm)	Titer (IU/mL)	AST (U/mL)	ALT (U/mL)	SRVR	RVR	EVR	ETR	SVR
pt1	M	60	60	169	80,700	45	36	N-C	Y	Y	Y	Y
pt2	F	30	56	160	36,600	23	36	N-C	Y	Y	Y	Y
pt3	F	47	65	158	131,000	94	47	Y	Y	Y	Y	Y
pt4	M	65	68	170	248,000	81	168	Y	Y	Y	Y	Y
pt5	F	48	52	160	4,100	28	5	Y	Y	Y	Y	Y
pt6	M	35	70	170	379,300	77	228	N	Y	Y	Y	Y
pt7	M	40	72	170	234,500	79	124	Y	Y	Y	Y	Y
pt8	M	26	82	178	148,300	180	250	N	Y	Y	Y	Y
pt9	M	31	85	172	282,100	63	198	Y	Y	Y	Y	Y
pt10	M	36	70	173	134,800	51	77	Y	Y	Y	Y	Y
pt11	M	37	70	170	237,200	141	121	Y	Y	Y	Y	Y
pt12	M	37	65	176	249,300	36	87	N	Y	Y	Y	Y
pt13	M	64	77	174	3,400	44	19	Y	Y	Y	Y	Y
pt14	F	62	53	153	20,000	35	54	N-C	Y	Y	Y	Y
pt15	M	49	76	178	497,600	68	105	Y	Y	Y	Y	Y
pt16	M	50	80	175	54,100	28	29	N-C	Y	Y	Y	Y
pt17	F	41	64	158	469,000	21	10	Y	Y	Y	Y	Y
pt18	M	39	70	170	3,400	213	701	Y	Y	Y	Y	Y
pt19	M	62	66	168	427,600	100	95	N-C	Y	Y	Y	Y
pt20	M	51	55	175	8,000	41	39	N-C	Y	Y	Y	Y
pt21	M	48	71	169	23,200	76	24	N-C	Y	Y	Y	Y
pt22	F	44	64	161	48,600	40	46	N-C	Y	Y	Y	Y
pt23	F	57	61	155	3,400	53	38	Y	Y	Y	Y	Y
pt24	M	48	59	154	48,300	23	15	Y	Y	Y	Y	Y
pt25	M	30	72	172	62,000	40	68	Y	Y	Y	Y	Y
pt26	M	37	75	172	179,300	39	67	N	Y	Y	Y	Y
pt27	M	47	72	170	379,300	68	97	Y	Y	Y	Y	Y
pt28	F	55	55	150	172,100	23	25	Y	Y	Y	Y	Y
pt29	M	65	57	171	106,900	46	72	Y	Y	Y	Y	Y
Mean± SD		46.2±11.5	67.0±8.9	167.3±8.0	131,000^∗	64.0±46.1	99.3±132.3
Mean± SD					(3400-497600)

SRVR, super-rapid virological response, HCV RNA negative at treatment week 2; RVR, rapid virological response, HCV RNA negative at treatment week 4; EVR, early virological response, HCV RNA negative at treatment week 12; ETR, end of treatment response, HCV RNA negative at the end of treatment; SVR, sustained virological response, HCV RNA negative 24 weeks after the end of treatment; Titer, HCV RNA titer; N-C, not checked; Y, yes; N, no.

^∗ Median (range).

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