Vnitr Lek 2009, 55(5):474-479

Efficacy of combination treatment with pegylated interferon plus ribavirin in patients chronically infected with HCV

P. Urbánek^1,*, I. Subhanová², E. Janoušová³, L. Dušek³, Z. Mareček¹, R. Brůha⁴, J. Petrtýl⁴, M. Brodanová⁵

¹ Interní klinika 1. lékařské fakulty UK a ÚVN Praha, přednosta pplk. prof. MUDr. Miroslav Zavoral, Ph.D.

² Ústav klinické biochemie a laboratorní diagnostiky 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Tomáš Zima, DrSc., MBA

³ Institut biostatistiky a analýz Lékařské fakulty MU Brno, přednosta doc. RNDr. Ladislav Dušek, Ph.D.

⁴ IV. interní klinika 1. lékařské fakulty UK a VFN Praha, přednosta prof. MUDr. Aleš Žák, DrSc.

⁵ I. interní klinika hematoonkologie 1. lékařské fakulty UK a VFN Praha, přednosta doc. MUDr. Marek Trněný, CSc.

The aim of the study:
To evaluate the efficacy of combined antiviral treatment with pegylated interferon α plus ribavirin in patients with chronic HCV infection who have not yet been treated with antivirals (treatment-naive patients). To compare the treatment effect in patients with low (< 600,000 IU/ml) and high (≥ 600,000 IU/ml) initial viremia.


Methods and treatment regime:
Treatment-naive patients with chronic HCV infection treated with the combination therapy of pegylated interferon-α2a plus ribavirin. Treatment response was evaluated at weeks 12, 24 and 48 when treatment was ongoing and at weeks 12, 24 and 48 after the treatment was finished. Commercially available sets from various manufacturers were used for serum and molecular genetic diagnostics of HCV infection.


Patient sample:
Antiviral treatment was initiated in 175 patients between 2001 and 2007. The complete data sets suitable for statistical analysis were available for 143 patients. End of treatment response and sustained viral response analyses were conducted separately for HCV genotype 1 (n = 124) and genotype 2 + 3 (n = 7).

Results:
In the genotype 1 group, 76% of patients achieved end of treatment response and 59% of patients achieved sustained viral response. Both types of response were observed in 100% of the genotype 2 and 3 infected patients. When a correlation between initial viremia and sustained viral response was analysed, no statistically significant difference was observed between patients with low (< 600,000 IU/ml) and high (≥ 600 000 IU/ml) initial viremia.

Conclusion:
The results observed in the present study are generally slightly better than comparable results from large registration studies. In contrary to the published literature, the threshold of 600,000 IU/ml for initial viremia did not correlate statistically significantly with SVR.

Keywords: hepatitis C; pegylated interferon; ribavirin

Received: November 24, 2008; Accepted: December 27, 2008; Published: May 1, 2009  Show citation