Basso M, Torre F, Grasso A, Percario G, Azzola E, Artioli S, Blanchi S, Pelli N, Picciotto A
Department of Internal Medicine, University of Genoa, Viale Benedetto XV, n. 6, 16132 Genoa, Italy.
Dig Liver Dis. 2007 Jan;39(1):47-51. doi: 10.1016/j.dld.2006.08.007. Epub 2006 Oct 31.
The re-treatment of patients who relapse after a course of standard interferon and ribavirin with pegylated interferon alfa-2b plus ribavirin is an open issue.
To evaluate efficacy and safety of treatment with pegylated interferon alfa-2b plus ribavirin and the role of early HCV-RNA assessment as a predictor of sustained response.
Between May 2001 and December 2002, 242 consecutive patients with chronic hepatitis C were enrolled in an open, regional, multicentre study. Seventy-eight of them were responder-relapsers to a previous course of combination therapy.
Patients were treated with pegylated interferon alfa-2b (1 microg/kg/week) plus ribavirin (800-1200 mg daily). Qualitative HCV-RNA was performed at week 2. Genotypes 1-4 were treated for 48 weeks, while genotypes 2 and 3 were treated for 24 weeks.
We obtained an overall sustained virological response rate of 41.0% (78.6% for patients with genotypes 2-3).
This treatment schedule prove to be safe and effective in relapsers with genotype non-1 while genotype 1-4 patients had a low rate of sustained virological response. Qualitative virological assessment after 2 weeks may identify patients who are more likely to reach sustained virological response, but it is not a valid tool for a stopping rule approach.
