Brief Articles
Copyright ©2010 Baishideng. All rights reserved.
World J Hepatol. Jun 27, 2010; 2(6): 226-232
Published online Jun 27, 2010. doi: 10.4254/wjh.v2.i6.226
Twenty four-week peginterferon plus ribavirin after interferon-β induction for genotype 1b chronic hepatitis C
Hiroaki Okushin, Kazuhiko Morii, Koichi Uesaka, Shiro Yuasa
Hiroaki Okushin, Kazuhiko Morii, Koichi Uesaka, Shiro Yuasa, Department of Internal Medicine, Himeji Red Cross Hospital, 1-12-1 Shimoteno, Himeji-shi, Hyogo 670-8540, Japan
Author contributions: Okushin H designed the study; Okushin H, Morii K, Uesaka K and Yuasa S performed the research; and Okushin H wrote the paper.
Correspondence to: Hiroaki Okushin, MD, Department of Internal Medicine, Himeji Red Cross Hospital, 1-12-1 Shimoteno, Himeji-shi, Hyogo 670-8540, Japan. hiroaki_okushin@hotmail.co.jp
Telephone: +81-79-2942251 Fax: +81-79-2964050
Received: February 12, 2010
Revised: March 10, 2010
Accepted: March 17, 2010
Published online: June 27, 2010
Abstract

AIM: To investigate the possibility of shortening the duration of peginterferon (Peg-IFN) plus ribavirin (RBV) combination therapy by incorporating interferon-β (IFN-β) induction therapy.

METHODS: A one treatment arm, cohort prospective study was conducted on seventy one patients. The patients were Japanese adults with genotype 1b chronic hepatitis C, HCV-RNA levels of ≥ 5.0 Log IU/mL or 100 KIU/mL, and platelet counts of ≥ 90 000/μL. The treatment regimen consisted of a 2 wk course of twice-daily administration of IFN-β followed by 24 wk Peg-IFN plus RBV combination therapy. We prolonged the duration of the Peg-IFN plus RBV therapy to 48 wk if the patient requested it.

RESULTS: The patients, including 44% males, were characterized by an median age of 63 years (range: 32-78 years), an median platelet count of 13.9 (range: 9.1-30.6) × 104/μL, 62% IFN-naïve, and median HCV-RNA of 6.1 (range: 5.1-7.2) Log IU/mL. The sustained virologic response (SVR) rates were 34% (Peg-IFN: 1-24 wk, n = 61, 95% confidence interval (CI): 24%-47%) and 55% (Peg-IFN: 20-24 wk, n = 31, 95% CI: 38%-71%, P < 0.001; vs Peg-IFN: 1-19 wk). The SVR rate when the administration was discontinued early was 13% (Peg-IFN: 1-19 wk, n = 30, 95% CI: 5%-30%), and that when the administration was prolonged was 50% (Peg-IFN: 25-48 wk, n = 10, 95% CI: 24%-76%, P < 0.05; vs Peg-IFN: 1-19 wk). In the patients who received 20-24 wk of Peg-IFN plus RBV, only the higher platelet count (≥ 130 000/μL) was significantly correlated with the SVR (odds ratio: 11.680, 95% CI: 2.3064-79.474, P = 0.0024). In 45% (14/31) of the patients with a higher platelet count (≥ 130 000/μL) before therapy, the HCV-RNA level decreased to below 3.3 Log IU/mL at the completion of IFN-β, and their SVR rate was 93% (13/14) after 20-24 wk administration of Peg-IFN plus RBV.

CONCLUSION: These results suggest the possibilities of shortening the duration of Peg-IFN plus RBV combination therapy by actively reducing HCV-RNA levels using the IFN-β induction regimen.

Keywords: Peginterferon; Ribavirin; Interferon-β; Induction therapy; Short-term therapy; Chronic hepatitis C; Genotype 1b