Abstract
Background
It is still not known which patients with chronic hepatitis C who failed to respond to previous pegylated interferon (Peg-IFN) plus ribavirin therapy can benefit from re-treatment.
Methods
Seventy-four patients (HCV genotype 1, n = 56, genotype 2, n = 18) were re-treated with Peg-IFN plus ribavirin.
Results
On re-treatment, the sustained virologic response (SVR) rate was 41% for genotype 1 and 56% for genotype 2. With genotype 1, the factors associated with an SVR were previous treatment response and the serum hepatitis C virus (HCV) RNA level at the start of re-treatment. Patients with a ≥2-log decrease in HCV RNA at week 12 (partial early virologic response, p-EVR) in previous treatment had significantly higher SVR rates than those without these decreases (p < 0.001); no patient without a p-EVR in the previous treatment attained an SVR with re-treatment (0/16). All patients with <5 log10 IU/ml of HCV RNA at the start of re-treatment attained an SVR (6/6), while only 33% (15/45) of those patients with ≥5 log10 IU/ml of HCV RNA attained an SVR (p < 0.01). Among the patients with relapse in the previous treatment, those who attained an SVR on re-treatment required a longer duration of re-treatment than the duration of the previous treatment (re-treatment, 63.8 ± 13.0 weeks vs. previous treatment, 53.9 ± 13.5 weeks, p = 0.01).
Conclusions
Re-treatment of genotype 1 patients should be limited to patients with a p-EVR in the previous treatment and a low HCV RNA level at the start of re-treatment. In re-treatment with Peg-IFN plus ribavirin, longer treatment duration can contribute to increasing the anti-viral effect.
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Acknowledgments
Other institutions and participants in the Osaka Liver Forum are: Higashiosaka City Central Hospital, S Iio; Itami City Hospital, Y Saji; Toyonaka Municipal Hospital, M Inada; Otemae Hospital, Y Doi; Suita Municipal Hospital, T Nagase; NTT West Osaka Hospital, A Kaneko; Ashiya Municipal Hospital, T Kitada; Nishinomiya Municipal Central Hospital, H Ogawa; Saiseikai Senri Hospital, K Suzuki; Izumiotsu Municipal Hospital, S Yamagata; Osaka Kaisei Hospital, N Imaizumi; Kano General Hospital, S Kubota; Saso Hospital, M Nishiuchi; and Meiwa Hospital, Y Hayakawa. This work was supported by a Grant-in-Aid for Research on Hepatitis and BSE from the Ministry of Health, Labour and Welfare of Japan, and Scientific Research from the Ministry of Education, Science, and Culture of Japan. All authors have no financial relationships relevant to this study.
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Oze, T., Hiramatsu, N., Yakushijin, T. et al. Efficacy of re-treatment with pegylated interferon plus ribavirin combination therapy for patients with chronic hepatitis C in Japan. J Gastroenterol 46, 1031–1037 (2011). https://doi.org/10.1007/s00535-011-0409-7
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DOI: https://doi.org/10.1007/s00535-011-0409-7