Clin Mol Hepatol.
2013 Mar;19(1):60-69. 10.3350/cmh.2013.19.1.60.
High effectiveness of peginterferon alfa-2a plus ribavirin therapy in Korean patients with chronic hepatitis C in clinical practice
- Affiliations
-
- 1Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
- 2Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. limys@amc.seoul.kr
- 3Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
- 4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 5Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 6Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
- KMID: 1493576
- DOI: http://doi.org/10.3350/cmh.2013.19.1.60
Abstract
- BACKGROUND/AIMS
Identifying the impact of a patient's ethnicity on treatment responses in clinical practice may assist in providing individualized treatment regimens for chronic hepatitis C (CHC). The effectiveness of standard peginterferon plus ribavirin therapy and the need for triple combination therapy with protease inhibitors in Koreans remain matters of debate. These issues were investigated in the present study.
METHODS
The clinical data of 272 treatment-naive Korean CHC patients who were treated in a community-based clinical trial (Clinical Trial group; n=51) and in clinical practice (Cohort group; n=221), were analyzed and compared. All were treated with standard protocols of peginterferon alfa-2a plus ribavirin therapy.
RESULTS
For patients with hepatitis C virus (HCV) genotype 1, the sustained virological response (SVR) rates in the Clinical Trial and Cohort groups were 81% (21/26) and 55% (58/106), respectively, by intention-to-treat (ITT) analysis (P=0.02), and 100% (13/13) and 80% (32/40), respectively, in treatment-adherent patients (P=0.18). For patients with HCV genotype 2, the SVR rates in these two groups were 96% (24/25) and 88% (101/115), respectively, by ITT analysis (P=0.31). Adherence and treatment duration were independent predictors of SVR for genotypes 1 and 2, respectively (P<0.01 for each). Korean patients with CHC achieved high SVR rates with peginterferon alfa-2a plus ribavirin in both the clinical trial and clinical practice settings.
CONCLUSIONS
Measures to raise adherence to standard therapy in clinical practice may improve the SVR rates in these patients as effectively as adding protease inhibitors, thus obviating the need for the latter.
MeSH Terms
-
Adolescent
Adult
Aged
Antiviral Agents/*therapeutic use
Asian Continental Ancestry Group
Cohort Studies
Drug Therapy, Combination
Female
Genotype
Hepacivirus/genetics
Hepatitis C, Chronic/*drug therapy
Humans
Interferon-alpha/*therapeutic use
Male
Middle Aged
Odds Ratio
Polyethylene Glycols/*therapeutic use
Predictive Value of Tests
RNA, Viral/genetics
Recombinant Proteins/therapeutic use
Republic of Korea
Ribavirin/*therapeutic use
Treatment Outcome
Young Adult
Antiviral Agents
Interferon-alpha
Polyethylene Glycols
RNA, Viral
Recombinant Proteins
Ribavirin
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