Digestive Diseases and Sciences

, Volume 58, Issue 5, pp 1371–1382

Estimates of HCV-1 Patients Attaining RVR Following Dual Therapy with Peg-Interferon and Ribavirin

  • A. Andriulli
  • A. Iacobellis
  • M. R. Valvano
  • F. Spirito
  • A. Ippolito
  • F. Bossa
  • F. Terracciano
  • R. Fontana
  • G. Niro
Original Article

DOI: 10.1007/s10620-012-2484-x

Cite this article as:
Andriulli, A., Iacobellis, A., Valvano, M.R. et al. Dig Dis Sci (2013) 58: 1371. doi:10.1007/s10620-012-2484-x

Abstract

Background

Given the significant side-effects and healthcare costs associated with telaprevir- or boceprevir-combination therapy, identifying patients likely to respond to dual therapy peg-interferon (Peg-IFN)/ribavirin is highly desirable. Since the perception of how large the pool of patients who may achieve rapid virologic response (RVR) is vaguely ascertained, we searched the literature for this information.

Methods

Studies on patients treated with Peg-IFN/ribavirin were identified by searching MEDLINE and analyzed by meta-analysis. The primary end point was weighted estimates of RVR. The influence on race/ethnicity, baseline viremia, type of Peg-IFN, ribavirin dosage, and significant hepatic fibrosis on the results was evaluated.

Results

Across 38 studies on 13,219 patients, the fraction of RVR patients was 19.6 %. The only baseline factor influencing RVR was race/ethnicity, with higher rates in Asian (26.7 %) and Caucasian patients (22.5 %). Of the 1,735 RVR patients, 85.1 % attained sustained virologic response (SVR). In these, SVR was influenced by ribavirin dose (86.8 vs. 72.8 % for high or low), type of Peg-IFN (91.8 % for alpha-2b vs. 82.9 % for alpha-2a), and treatment duration (91.7 % for 48 weeks vs. 79.4 % for 24 weeks).

Conclusions

One fifth to one fourth of hepatitis C virus genotype 1 (HCV-1) patients can be safely treated with dual therapy of Peg-IFN/ribavirin, and may be spared from cost and inconvenience of regimens considering the addition of HCV protease inhibitors.

Keywords

HCV HCV infection Chronic viral hepatitis Therapy Peg-interferon Ribavirin Race Ethnicity 

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • A. Andriulli
    • 1
  • A. Iacobellis
    • 1
  • M. R. Valvano
    • 1
  • F. Spirito
    • 1
  • A. Ippolito
    • 1
  • F. Bossa
    • 1
  • F. Terracciano
    • 1
  • R. Fontana
    • 1
  • G. Niro
    • 1
  1. 1.Division of Gastroenterology“Casa Sollievo Sofferenza” Hospital, IRCCSSan Giovanni RotondoItaly

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