Low-Dose Pegylated Interferon α-2b Plus Ribavirin for Elderly and/or Cirrhotic Patients with Genotype 2 Hepatitis C Virus
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: This study aimed to predict sustained viral response (SVR) to low-dose pegylated interferon (PEGIFN) plus ribavirin of elderly and/or cirrhotic patients with genotype 2 hepatitis C virus (HCV) using viral response within 2 weeks. Methods: Low-dose PEG-IFN-α-2b plus ribavirin was administered to 50 elderly and/or cirrhotic patients with genotype 2 HCV for 24 weeks. The dynamics of HCV RNA and HCV core antigen levels within 2 weeks were measured. Results: The patients’ median age was 66 years. There were 21 male and 29 female patients. The median baseline HCV RNA level was 5.7 log IU/mL. Rapid viral response was achieved in 17 patients (34%), SVR in 28 (56%), and two (4%) discontinued treatment. Univariate analysis of factors contributing to SVR showed significant differences for sex, baseline virus level, and response within 4 weeks. When 40 fmol/L was set as the cutoff value for the core antigen level at 1 week, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for predicting SVR were 93%, 75%, 84%, 88%, and 85%, respectively. Conclusions: Low-dose PEG-IFN plus ribavirin was a safe and costeffective treatment for elderly and/or cirrhotic patients with genotype 2 HCV, and the viral response within 2 weeks was a useful predictor of SVR.
Abstract
Background/Aims: This study aimed to predict sustained viral response (SVR) to low-dose pegylated interferon (PEGIFN) plus ribavirin of elderly and/or cirrhotic patients with genotype 2 hepatitis C virus (HCV) using viral response within 2 weeks. Methods: Low-dose PEG-IFN-α-2b plus ribavirin was administered to 50 elderly and/or cirrhotic patients with genotype 2 HCV for 24 weeks. The dynamics of HCV RNA and HCV core antigen levels within 2 weeks were measured. Results: The patients’ median age was 66 years. There were 21 male and 29 female patients. The median baseline HCV RNA level was 5.7 log IU/mL. Rapid viral response was achieved in 17 patients (34%), SVR in 28 (56%), and two (4%) discontinued treatment. Univariate analysis of factors contributing to SVR showed significant differences for sex, baseline virus level, and response within 4 weeks. When 40 fmol/L was set as the cutoff value for the core antigen level at 1 week, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for predicting SVR were 93%, 75%, 84%, 88%, and 85%, respectively. Conclusions: Low-dose PEG-IFN plus ribavirin was a safe and costeffective treatment for elderly and/or cirrhotic patients with genotype 2 HCV, and the viral response within 2 weeks was a useful predictor of SVR.
참고문헌 (26)
- Asahina Y, "Effect of aging on risk for hepatocellular carcinoma in chronic hepatitis C virus infection", Hepatology, 52, pp.518~527 (2010)
- Editors of the Drafting Committee for Hepatitis Management Guidelines: The Japan Society of Hepatology, "Guidelines for the management of hepatitis C virus infection: first edition, May 2012, The Japan Society of Hepatology", Hepatol Res, 43, pp.1~34 (2013)
- Morgan TR, "Outcome of sustained virological responders with histologically advanced chronic hepatitis C", Hepatology, 52, pp.833~844 (2010)
- Huang CF, "Efficacy and safety of pegylated interferon combined with ribavirin for the treatment of older patients with chronic hepatitis C", J Infect Dis, 201, pp.751~759 (2010)
- Bota S, "Severe adverse events during antiviral therapy in hepatitis C virus cirrhotic patients: a systematic review", World J Hepatol, 5, pp.120~126 (2013)
- Meyer-Wyss B, "Comparison of two PEGinterferon alpha-2b doses (1.0 or 1.5 microg", kg) combined with ribavirin in interferon-naive patients with chronic hepatitis C and up to moderate fibrosis, 2006, pp.13, 457~465
- Roffi L, "Pegylated interferon-alpha2b plus ribavirin: an efficacious and well-tolerated treatment regimen for patients with hepatitis C virus related histologically proven cirrhosis", Antivir Ther, 13, pp.663~673 (2008)
- Tamai H, "Prediction of sustained response to low-dose pegylated interferon alpha-2b plus ribavirin in patients with genotype 1b and high hepatitis C virus level using viral reduction within 2 weeks after therapy initiation", Hepatol Res, 41, pp.1137~1144 (2011)
- Tamai H, "Low-dose pegylated interferon-alpha2a plus ribavirin therapy for elderly and", or cirrhotic patients with HCV genotype-1b and high viral load, 2014, pp.19, 107~115
- Kumada H, "Daclatasvir plus asunaprevir for chronic HCV genotype 1b infection", Hepatology, 59, pp.2083~2091 (2014)
- Zeuzem S, "Sofosbuvir and ribavirin in HCV genotypes 2 and 3", N Engl J Med, 370, pp.1993~2001 (2014)
- Omata M, "Sofosbuvir plus ribavirin in Japanese patients with chronic genotype 2 HCV infection: an open-label, phase 3 trial", J Viral Hepat, 21, pp.762~768 (2014)
- Steinbrook R, "The high price of the new hepatitis C virus drugs", JAMA Intern Med, 174, pp.1172~ (2014)
- Murakami E, "Ultradeep sequencing study of chronic hepatitis C virus genotype 1 infection in patients treated with daclatasvir, peginterferon, and ribavirin", Antimicrob Agents Chemother, 58, pp.2105~2112 (2014)
- Abergel A, "Peginterferon alpha-2b plus ribavirin for treatment of chronic hepatitis C with severe fibrosis:a multicentre randomized controlled trial comparing two doses of peginterferon alpha-2b", J Viral Hepat, 13, pp.811~820 (2006)
- Fried MW, "Rapid virological response is the most important predictor of sustained virological response across genotypes in patients with chronic hepatitis C virus infection", J Hepatol, 55, pp.69~75 (2011)
- Simmonds P, "Classification of hepatitis C virus into six major genotypes and a series of subtypes by phylogenetic analysis of the NS-5 region", J Gen Virol, 74(11), pp.2391~2399 (1993)
- Roomer R, "Risk factors for infection during treatment with peginterferon alfa and ribavirin for chronic hepatitis C", Hepatology, 52, pp.1225~1231 (2010)
- Manns MP, "Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial", Lancet, 358, pp.958~965 (2001)
- Ghany MG, "Diagnosis, management, and treatment of hepatitis C: an update", Hepatology, 49, pp.1335~1374 (2009)
- Manns M, "Reduced dose and duration of peginterferon alfa-2b and weight-based ribavirin in patients with genotype 2 and 3 chronic hepatitis C", J Hepatol, 55, pp.554~563 (2011)
- Inoue Y, "Factors affecting efficacy in patients with genotype 2 chronic hepatitis C treated by pegylated interferon alpha-2b and ribavirin: reducing drug doses has no impact on rapid and sustained virological responses", J Viral Hepat, 17, pp.336~344 (2010)
- Petta S, "Optimal therapy in hepatitis C virus genotypes 2and 3 patients", Liver Int, 31(1), pp.36~44 (2011)
- Wada Y, "Prediction of efficacy to pegylated interferon-alpha-2b plus ribavirin in patients with genotype 2hepatitis C virus using viral response within 2 weeks", Hepatol Res, 44, pp.179~186 (2014)
- Hayashi K, "Usefulness of a new immuno-radiometric assay to detect hepatitis C core antigen in a community-based population", J Viral Hepat, 12, pp.106~110 (2005)
- Jeng WJ, "None of the six SNPs of IL28B could predict treatment responses in genotype 2 chronic HCV infected patients by propensity score matching analysis", PLoS One, 7, pp.e48217~ (2012)