Vol. 53, No. 1, 2010
Issue release date: January 2010
Intervirology 2010;53:55–59
(DOI:10.1159/000252785)
Original Article
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Prolonged PEG-IFN and RBV Is Effective in Patients with HCV Genotype 1 and High Viral Load Who Achieved Virological Response Later than 24 Weeks

Ueda T. · Chung H. · Kudo M. · Ishikawa E. · Hayaishi S. · Tatsumi C. · Inoue T. · Yada N. · Hagiwara S. · Minami Y. · Ueshima K.
Department of Gastroenterology and Hepatology, Kinki University School of Medicine, Osaka-Sayama, Japan
email Corresponding Author


 goto top of outline Key Words

  • Genotype 1
  • Hepatitis C virus
  • High viral load
  • Late virological responder
  • Peginterferon
  • Ribavirin
  • Sustained virological response

 goto top of outline Abstract

Objective: The extension of treatment duration has been proposed in late virological responders with hepatitis C virus (HCV) genotype 1 and high viral load. However, the effectiveness of extended treatment in patients whose serum HCV RNA become undetectable later than 24 weeks of treatment (ultra-late virological responder; ULVR) has not yet been determined. Methods: A total of 130 patients infected with HCV genotype 1 and who had high viral load were treated with pegylated interferon (PEG-IFN) and ribavirin (RBV) combination therapy. We retrospectively analyzed 10 ULVR who received extended combination treatment beyond 48 weeks. Results: The duration of the combination treatment for ULVR ranged between 59 and 119 weeks, and the mean duration was 80 weeks. Although the majority of ULVR were older female patients (≧60 years) with factors related to poor therapeutic response, 8 patients (80%) achieved sustained virological response (SVR). The SVR rate correlated well with the duration of the treatment. Five ULVR achieved SVR when treatment was continued until serum HCV RNA remained undetectable for longer than 48 weeks. Conclusion: The extended duration of PEG-IFN and RBV combination treatment is a possible strategy to improve treatment response in HCV genotype 1 infection, even for ULVR.

Copyright © 2010 S. Karger AG, Basel


 goto top of outline References
  1. Manns MP, McHutchinson JG, Gordon SC, Rustgi VK, Shiffman M, Reindollar R, Goodman ZD, Koury K, Ling M, Albrecht JK: Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomized trial. Lancet 2001;358:958–965.
  2. Fried MW, Shiffman ML, Reddy KR, Smith C, Marinos G, Goncales FL Jr, Haussinger D, Diago M, Carosi G, Dhumeaux D, Craxi A, Lin A, Hoffman J, Yu J: Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 2002;347:975–982.
  3. Berg T, von Wagner M, Nasser S, Sarrazin C, Heintges T, Gerlach T, Buggisch P, Goeser T, Rasenack J, Page GR, Schmidt WE, Kallinowski B, Klinker H, Spengler U, Martus P, Alshuth U, Zeuzem S: Extended treatment duration for hepatitis C virus type 1: comparing 48 versus 72 weeks of peginterferon-alfa-2a plus ribavirin. Gastroenterology 2006;130:1086–1097.
  4. Pearlman BL, Ehleben C, Saifee S: Treatment extension to 72 weeks of peginterferon and ribavirin in hepatitis C genotype 1-infected slow responders. Hepatology 2007;46:1688–1694.
  5. Enomoto N, Sakuma I, Asahina Y, Kurosaki M, Murakami T, Yamamoto C, Izumi N, Marumo F, Sato C: Comparison of full-length sequences of interferon-sensitive and resistant hepatitis C virus 1b. Sensitivity to interferon is conferred by amino acid substitutions in the NS5A region. J Clin Invest 1995;96:224–230.
  6. Enomoto N, Sakuma I, Asahina Y, Kurosaki M, Murakami T, Yamamoto C, Ogura Y, Izumi N, Marumo F, Sato C: Mutations in the nonstructural protein 5A gene and response to interferon in patients with chronic hepatitis C virus 1b infection. N Engl J Med 1996;334:77–81.
  7. Akuta N, Suzuki F, Sezaki H, Suzuki Y, Hosaka T, Someya T, Kobayashi M, Saitoh S, Watahiki S, Sato J, Matsuda M, Kobayashi M, Arase Y, Ikeda K, Kumada H: Association of amino acid substitution pattern in core protein of hepatitis C virus genotype 1b high viral load and non-virological response to interferon-ribavirin combination therapy. Intervirology 2005;48:372–380.
  8. Akuta N, Suzuki F, Kawamura Y, Yatsuji H, Sezaki H, Suzuki Y, Hosaka T, Kobayashi M, Kobayashi M, Arase Y, Ikeda K, Kumada H: Predictive factors of early and sustained responses to peginterferon plus ribavirin combination therapy in Japanese patients infected with hepatitis C virus genotype 1b: amino acid substitutions in the core region and low-density lipoprotein cholesterol levels. J Hepatol 2007;46:403–410.
  9. Okanoue T, Itoh Y, Hashimoto H, Yasui K, Minami M, Takehara T, Tanaka E, Onji M, Toyoda J, Chayama K, Yoshioka K, Izumi N, Akuta N, Kumada H: Predictive values of amino acid sequences of the core and NS5A regions in antiviral therapy for hepatitis C: a Japanese multi-center study. J Gastroenterol 2009;44:952–963.

 goto top of outline Author Contacts

Masatoshi Kudo, MD, PhD
Department of Gastroenterology and Hepatology
Kinki University School of Medicine
377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511 (Japan)
Tel. +81 72 366 0221, Fax +81 72 367 2880, E-Mail m-kudo@med.kindai.ac.jp


 goto top of outline Article Information

Published online: January 5, 2010
Number of Print Pages : 5
Number of Figures : 2, Number of Tables : 1, Number of References : 9


 goto top of outline Publication Details

Intervirology (International Journal of Basic and Medical Virology)

Vol. 53, No. 1, Year 2010 (Cover Date: January 2010)

Journal Editor: Liebert U.G. (Leipzig)
ISSN: 0300-5526 (Print), eISSN: 1423-0100 (Online)

For additional information: http://www.karger.com/INT


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