Korean J Hepatol.  2009 Mar;15(1):70-79. 10.3350/kjhep.2009.15.1.70.

Durability of a sustained virologic response in combination therapy with interferon/peginterferon and ribavirin for chronic hepatitis C

• Kim CH
• Park BD
• Lee JW
• Kim YS
• Jeong S
• Lee DH
• Kim HG
• Shin YW
• Kwon KS
• Lee JI

• KMID: 1776816
• DOI: http://doi.org/10.3350/kjhep.2009.15.1.70

Abstract

BACKGROUNDS/AIMS
The ultimate goal of antiviral therapy using interferon/pegylated interferon combined with ribavirin in chronic C-viral hepatitis is to achieve a sustained virologic response (SVR). Several studies have shown that the reappearance rate of hepatitis C virus (HCV) RNA in serum after the achievement of an SVR is less than 1%; the durability of an SVR in Korean patients is not known. The aim of this study was to determine the durability of the virologic response in chronic hepatitis C patients with an SVR to antiviral therapy.
METHODS
A total of 156 patients who were treated successfully with interferon/peginterferon and ribavirin were evaluated retrospectively. Patients received either subcutaneous conventional interferon alpha 3x10(6) units three times a week or subcutaneous pegylated interferon (alpha-2a: 180 microgram, alpha-2b: 80-100 microgram) once a week in combination with ribavirin at 600-1,200 mg daily (depending on body weight). Patients with HCV genotype 1 were treated for 48 weeks, whereas those with non-genotype 1 were treated for 24 weeks.
RESULTS
Eighty-two patients underwent treatment with conventional interferon and ribavirin, whereas 74 patients were treated with pegylated interferon and ribavirin. An SVR was achieved in 73 patients (73/156, 46.8%). HCV RNA reappeared in eight patients (8/73, 11.0%; detected by qualitative PCR), including one patient with persistent viremia (1/73, 1.4%).
CONCLUSIONS
Reappearance of HCV RNA after earlier achievement of an SVR might appear more frequently than previously reported. Close follow-up of these patients is recommended and the implication of temporary viremia should be determined in the future.

Keyword

Hepatitis C; Therapeutics; Interferons; Ribavirin

MeSH Terms

Adult
Antiviral Agents/*therapeutic use
Drug Therapy, Combination
Female
Genotype
Hepatitis C, Chronic/*drug therapy
Humans
Interferon Alfa-2a/*therapeutic use
Interferon-alpha/*therapeutic use
Male
Middle Aged
Polyethylene Glycols/*therapeutic use
RNA, Viral/metabolism
Recurrence
Retrospective Studies
Ribavirin/*therapeutic use
Viremia/drug therapy