Clin Mol Hepatol.  2012 Sep;18(3):272-278. 10.3350/cmh.2012.18.3.272.

A reduced dose of ribavirin does not influence the virologic response during pegylated interferon alpha-2b and ribavirin combination therapy in patients with genotype 1 chronic hepatitis C

• You BC
• Kim YS
• Kim HI
• Kim SH
• Park SS
• Seo YR
• Kim SG
• Lee SW
• Kim HS
• Jeong SW
• Jang JY
• Kim BS

• KMID: 1392906
• DOI: http://doi.org/10.3350/cmh.2012.18.3.272

Abstract

BACKGROUND/AIMS
When combined with pegylated interferon alpha-2b (Peg-IFN alpha-2b) for the treatment of genotype 1 chronic hepatitis C (CHC) in Korea, the current guideline for the initial ribavirin (RBV) dose is based on body weight. However, since the mean body weight is lower for Korean patients than for patients in Western countries, current guidelines might result in Korean patients being overdosed with RBV.
METHODS
We retrospectively reviewed the medical records of patients with genotype 1 CHC who were treated with Peg-IFN alpha-2b and RBV combination therapy. We divided the patients into groups A (> or =15 mg/kg/day, n=23) and B (<15 mg/kg/day, n=26), given that the standard dose is 15 mg/kg/day. The clinical course in terms of the virologic response, adverse events, and dose modification rate was compared between the two groups after therapy completion.
RESULTS
The early response rates (92.0% vs. 83.3%, P=0.634) and sustained virologic response rates (82.6% vs. 73.1%, P=0.506) did not differ significantly between the two groups. During the treatment period, the RBV dose reduction rate was significantly higher in group A than in group B (60.9% vs. 23.1%, P=0.01).
CONCLUSIONS
RBV dose reduction is performed frequently when patients are treated according to the current Korean guidelines. Given that lowering the RBV dose did not appear to decrease the virologic response during therapy, reducing RBV doses below the current Korean guideline may be effective for treatment, especially in low-weight patients.

Keyword

Ribavirin; Pegylated interferon alpha-2b; Chronic hepatitis C; Sustained virologic response; Koreans

MeSH Terms

Antiviral Agents/pharmacology/*therapeutic use
Body Mass Index
Body Weight
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Therapy, Combination
Female
Genotype
Hepacivirus/drug effects
Hepatitis C, Chronic/*drug therapy/virology
Humans
Interferon-alpha/pharmacology/*therapeutic use
Male
Polyethylene Glycols/pharmacology/*therapeutic use
RNA, Viral/analysis
Recombinant Proteins/pharmacology/therapeutic use
Retrospective Studies
Ribavirin/pharmacology/*therapeutic use
Sex Factors
Treatment Outcome