Peginterferon alfa‐2b plus weight‐based ribavirin for 24 weeks in patients with chronic hepatitis C virus genotype 1 with low viral load who achieve rapid viral response

Abstract

SUMMARY. In chronic hepatitis C (CHC), treatment duration may be individualized according to time to first undetectable hepatitis C virus (HCV) RNA, with patients who attain undetectable HCV RNA early in treatment being candidates for shorter regimens. The aim of this study was to determine the relapse rate in patients with CHC genotype (G) 1 infection and low baseline viral load who achieved undetectable HCV RNA by week 4 [rapid virologic response (RVR)] when treated for 24 weeks. This was an open-label, multicentre, noninterventional study. Adult patients with G1 CHC infection and baseline viral load <600,000 IU/mL who attained RVR were treated with peginterferon alfa-2b (1.5 lg/kg/week) plus ribavirin (800-1200 mg/day) for 24 weeks, then followed for a further 24 weeks. The primary endpoint was relapse rate, defined as the proportion of patients with undetectable HCV RNA at treatment week 24 and detectable HCV RNA at week 24 follow-up. The secondary efficacy endpoint was sustained virologic response (SVR). Overall, 170 patients were included in the efficacy-evaluable population. The relapse rate was 9.7% (16/165, 95% confidence interval: 0.06-0.15), and SVR was attained by 149 of 170 patients (87.6%). Virologic outcomes were consistent regardless of age, gender, body weight and genotype. Seven patients reported treatment-emergent serious adverse events (AEs), and four patients discontinued treatment because of an AE. This study further demonstrates that peginterferon alfa-2b plus weight-based ribavirin for 24 weeks is an effective treatment strategy for treatment-naive patients with G1 CHC and low viral load who attain RVR.

Clinicopathologic characteristics and treatment of marginal zone lymphoma of mucosa‐associated lymphoid tissue (MALT lymphoma)

“…Treatment with pegylated IFN, with or without ribavirin, results in remission rates of 75% in patients with MZL 114 and mixed cryoglobulinemia. 115 The 5-year PFS and OS rates for patients treated with upfront antiviral therapy were 78% and 92%, respectively, and anti-HCV therapy at any time was independently associated with better OS. In addition, the outcome seems to be significantly better when pegylated IFN is used.…”

“…Antiviral therapy is successfully used in different non‐Hodgkin lymphoma subtypes but is more frequently being applied in MZLs. Treatment with pegylated IFN, with or without ribavirin, results in remission rates of 75% in patients with MZL and mixed cryoglobulinemia . The 5‐year PFS and OS rates for patients treated with upfront antiviral therapy were 78% and 92%, respectively, and anti‐HCV therapy at any time was independently associated with better OS.…”

Chronic Hepatitis C in Children: Problems and Prospects

“…Рибавирин является аналогом гуанозина, предотвращающего синтез РНК HCV путем ингибирования РНК-полимеразы. При лечении взрослых он вызывает СВО у 50% пациентов с генотипом 1 и у 80% больных с генотипами 2 и 3 [44,52,54].…”

“…В крупных педиатрических исследованиях продемонстрировано [44], что комбинированная терапия пегилированным ИФН α и рибавирином приводит к СВО более чем у 1/2 больных с генотипами 1, 4, 5 и 6, и более чем у 90% пациентов с генотипами 2 и 3 [52,54,55].…”

Hepatitis C genotype 1 virus with low viral load and rapid virologic response to peginterferon/ribavirin obviates a protease inhibitor

“…A multitude of studies have demonstrated that genotype 1‐infected treatment‐naïve patients with LVL at baseline who achieve RVR can be treated with 24 weeks of PEG/RBV therapy without compromising SVR rates . Based on one of these trials, the European Medicines Agency (EMA) has approved the use of 24 weeks of PEG/RBV in genotype 1‐infected patients with low baseline viral loads (<600,000 IU/mL) who achieve RVR …”