Combination Therapy of Peginterferon and Ribavirin for Chronic Hepatitis C Patients with Genotype 1b and Low-virus Load

Abstract

Objective

Very Low Viral Load (VLVL) Relapse Following Treatment of Naïve Patients with Chronic Hepatitis C

“…Because of the low viral levels, the patients were re-treated with lower doses than the initial treatment and experienced RVR (in contrast with the initial treatment) so re-treatment was shortened to 6 months. The combination of RVR and low viral load enables shorter treatment for genotype 1 patients [24]. Unlike the usual re-treatment that requires more intense or longer treatment to obtain a high level of success, SVR occurred for all patients.…”

“…The low viral RNA in blood after treatment raised the question of whether low-dose or short re-treatment might be effective as has been seen in other settings [36,37] associated with a low viral load [24,38] and it is reasonable to extend this consideration even in the setting of cirrhosis. Cirrhosis is a known factor that lowers the SVR generally by increasing the rate of relapse [39].…”

“…Perhaps, the SVR in previous studies of relapse patients could have been achieved in many patients without longer or stronger re-treatment. One study that evaluated genotype 1 patients with viral RNA \100,000 IU/ml demonstrated a very high SVR [24]. Many of these patients (47%) had been previously treated with interferon and 43/60 had a prior HCV RNA level [100,000.…”

Guidelines for the Management of Hepatitis C Virus Infection

“…Approximately 50% of SVR rates can be achieved with standard IFN monotherapy for 24–48 weeks as well . Peg‐IFN + ribavirin combination therapy has been reported to yield SVR rates ≥80% in this patient group, but is not approved by Japanese national medical insurance.…”

“…When the previous therapy included ribavirin, treatment with Peg‐IFN + ribavirin therapy (24–48 weeks) should be considered. High SVR rates comparable to those achieved with initial treatment have been reported . As with patients with genotype 2 and a high viral load, if Peg‐IFN‐α is contraindicated due to depression or depressive symptoms, IFN‐β can be used instead of Peg‐IFN …”