Efficacy of Peginterferon alfa-2a and Ribavirin Combination Therapy in Treatment-naive Estonian Patients with Chronic Hepatitis C

Abstract

Aim: The aim of the study was to assess the efficacy of pegylated interferon (Peg-IFN) α-2a and ribavirin (RBV) combination therapy in treatmentnaive patients with chronic hepatitis C in Estonia. Methods: Out of 121 outpatients with chronic hepatitis C (73 males, 48 females, aged 19−63) enrolled in the study, 76 were infected with HCV genotype 1b and 45 with genotype 3a. At baseline, the viral load in 75.2% of patients was higher than 600,000 IU/mL. Histologically, 88.4% of patients had fibrosis score F0−2. Patients received 180 μg of Peg-IFN α-2a weekly plus daily ribavirin 1,000 or 1,200 mg, depending on body weight, in HCV genotype 1b, or 800 mg/day in genotype 3a infection. Results: The overall sustained virologic response (SVR) rate in our study was 60.3%, being statistically lower for patients with HCV genotype 1b as compared to patients with genotype 3a (46.1% vs. 84.4%, p<0.05). The non-response and relapse rates were significantly higher in patients infected with HCV genotype 1b compared with patients infected with genotype 3a (19.7% vs. 2.2%, p=0.01; and 17.1% vs. 4.4%, p=0.04; respectively). The SVR rate was higher in patients younger than 40 years compared with older patients (76.4% vs. 47.0%, p<0.01), regardless of the genotype. Thirteen patients infected with HCV genotype 1b required dose reduction of PegIFN and/or RBV because of adverse side effects. Nine of them achieved SVR. Conclusion: HCV genotype and age younger than 40 years predetermined SVR rate in treatment-naive Estonian patients with chronic hepatitis C treated with Peg-IFN α-2a plus ribavirin.

Predictors of treatment response in patients with hepatitis C 1b genotype

“…The rate of SVR in the current study was 50%, which is consistent with our previous data [30], as well as with the results obtained from clinical trials [12][13][14][15] and from "real life" clinical settings [31,32].…”

An international perspective on using opioid substitution treatment to improve hepatitis C prevention and care for people who inject drugs: Structural barriers and public health potential

“…The EHIF will cover HCV treatment for persons who are insured by the fund, yet current national HCV treatment guidelines consider injection drug use as a contraindication for HCV treatment, and do not specify any period of abstinence to qualify for treatment. (Margus, Salupere, & Ott, 2010; World Health Organization, 2013) Nevertheless, 12 % (Tuuling, 2011) to 28% (Brjalin, et al, 2012) of people in HCV treatment attribute their HCV infection to past injection drug use.…”

Evaluation of response to treatment with Ribavirin plus Peginterferon in patients with chronic hepatitis C genotype 1b

“…In a research study, Vadim et al found that the SVR in Genotype 1b 1 was 46.1% (19). In another study conducted by Zeuzem et al, SVR was 50% (21).…”

“…Javier et al observed that older age is associated with a lower rate of response to treatment (18). Vadim et al also concluded that the SVR rate in patients younger than 40 years old, compared to older people, is higher (19). Zeuzem et al in their study found that, some predictive factors including age, base HCV-RNA and the duration of treatment were significantly associated with SVR; however, it has no significant relationship with gender, race, weight, source of exposure, duration of exposure, the dose of Ribavirin, Metavir and Knodell scores (21).…”