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Effective prediction of outcome of combination therapy with pegylated interferon alpha 2b plus ribavirin in Japanese patients with genotype-1 chronic hepatitis C using early viral kinetics and new indices

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

The rates of sustained virologic response (SVR) and relapse with pegylated interferon alpha 2b (peginterferon) plus ribavirin in patients with genotype-1 chronic hepatitis C (CHC) are approximately 50 and 30%, respectively. We investigated whether SVR and transient response (TR) can be differentiated during treatment using new indices calculated from early viral kinetics and the timing of when hepatitis C virus (HCV)-RNA becomes undetectable.

Methods

Peginterferon alpha 2b (1.5 μg/kg per week) plus weight-based ribavirin (600–1,000 mg/day) were administered to 141 patients with genotype-1 CHC for 48 weeks. The HCV-RNA loads were measured at baseline, 24 h, week 1, and week 2. The rebound index (RI, viral load at week 1 divided by viral load at 24 h) and the second rebound index (RI-2nd, viral load at week 2 divided by viral load at 24 h) were calculated.

Results

With SVR, the viral load was reduced at 24 h, did not rise during week 1 (RI ≤ 1.0), and was significantly reduced at week 2 (P < 0.05). Viral loads with TR and non-response increased at week 1. The SVR rate was 90% with RI ≤ 1.0, 96% with rapid viral responders, and 93% with RI-2nd <0.7 and week 8 early viral responders. The SVR rate with these 3 groups was 90% and administration for 48 weeks was recommended. With other groups, the SVR rate was 23% and the TR rate was 77%. Administration for 72 weeks was therefore recommended.

Conclusions

We distinguished SVR from TR during treatment using two indices (RI and RI-2nd) and the timing of HCV-RNA negativity.

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Abbreviations

SVR:

Sustained virologic response

TR:

Transient response

NR:

Non-response

RI:

Rebound index

RI-2nd:

Second rebound index

RVR:

Rapid viral responder

W8EVR:

Week 8 early viral response

W12EVR:

Week 12 early viral response

LVR:

Late viral responder

NVR:

Non-viral responder

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Authors and Affiliations

  1. The Center for Liver Diseases, Shin-Kokura Hospital, 1-3-1 Kanada, Kokurakitaku, Kitakyushu, Fukuoka, 803-8505, Japan

    Hideyuki Nomura, Yugo Miyagi & Hironori Tanimoto

  2. Department of Internal Medicine, Higashi Hospital, Fukuoka, Japan

    Masashi Higashi

  3. Clinical Research Center, National Nagasaki Medical Center, Nagasaki, Japan

    Hiromi Ishibashi

Authors
  1. Hideyuki Nomura
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  2. Yugo Miyagi
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  3. Hironori Tanimoto
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  4. Masashi Higashi
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  5. Hiromi Ishibashi
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Correspondence to Hideyuki Nomura.

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Nomura, H., Miyagi, Y., Tanimoto, H. et al. Effective prediction of outcome of combination therapy with pegylated interferon alpha 2b plus ribavirin in Japanese patients with genotype-1 chronic hepatitis C using early viral kinetics and new indices. J Gastroenterol 44, 338–345 (2009). https://doi.org/10.1007/s00535-009-0008-z

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  • DOI: https://doi.org/10.1007/s00535-009-0008-z

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