Prospective study of short-term peginterferon-α-2a monotherapy in patients who had a virological response at 2 weeks after initiation of interferon therapy

Department of Medicine and Molecular Science, Hiroshima University, Hiroshima, Japan.
Journal of Gastroenterology and Hepatology (Impact Factor: 3.5). 05/2008; 23(4):541-5. DOI: 10.1111/j.1440-1746.2008.05356.x
Source: PubMed


Long-term interferon (IFN) therapy is effective in eliminating hepatitis C virus (HCV). However, it carries the risk of adverse effects and reduced quality of life. To assess whether short-term IFN therapy effectively eliminates HCV, we performed a prospective pilot study of pegylated (peg)IFN-alpha-2a therapy for 8 or 24 weeks.
After excluding patients with high titers of genotype-1, 55 HCV patients received pegIFN-alpha-2a. Patients who became negative for HCV-RNA at week 2 were allocated to either an 8-week (n = 19) or 24-week (n = 15) course of IFN. We evaluated the efficacy of and tolerance to IFN therapy.
The sustained virological response rate was excellent in the two groups (8 weeks, 89.5% [17/19]; 24 weeks, 100% [15/15], respectively,). IFN dose reduction was required in one patient of the 8-week group, but in six patients of the 24-week group (P = 0.028). Treatment was completed by all patients of the 8-week group, but discontinued in five patients of the 24-week group (P = 0.011).
The 8-week IFN therapy is more tolerable than the 24-week therapy and had similar outcomes. Excluding the patients with high titers of genotype-1, we recommend switching to an 8-week course of pegIFN-alpha monotherapy once patients show an ultra rapid virological response at week 2 from the start of IFN therapy.

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    ABSTRACT: To assess the efficacy and advantages of 4-wk pegylated interferon alpha-2a (peg-IFN-alpha 2a) monotherapy for chronic hepatitis C patients with strong predictors of sustained virologic response (SVR). Patients (n = 33) with genotype 2 and low viral load (< 100 KIU/mL), who became HCV RNA negative after 1 wk of IFN treatment, were randomly allocated to receive a 4- or 12-wk treatment course at a ratio of 2:1, respectively, with a subsequent 24-wk follow-up period. Peg-IFN-alpha 2a was administered subcutaneously at a dose of 180 microg or 90 microg once weekly. SVR was defined as absence of serum HCV RNA at the end of the follow-up period. All patients completed the treatment schedule, and more than half were symptom-free during the treatment. In the 4-wk treatment group, 20 of 22 (91%) patients achieved SVR. Two patients relapsed, but achieved SVR following re-treatment with peg-IFN-alpha 2a alone. In the 12-wk treatment group, 11 of 11 (100%) patients attained SVR. Our results show that a 4-wk course of peg-IFN-alpha 2a monotherapy can achieve a high SVR rate in "IFN-sensitive" patients, without negatively affecting outcome.
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    Piel 07/2009; 24(6):292-299. DOI:10.1016/S0213-9251(09)71644-2
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