Pegylated interferon and ribavirin failures : Is retreatment an option?

Currently, there are limited therapeutic options available for chronic hepatitis C (HCV) patients who fail treatment with peginterferon alpha (PEG IFN) + ribavirin (RBV). An option is retreatment with a second course PEG-IFN + RBV. However, the virologic clearance with this option is unknown. Thus,...

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Bibliographic Details
Published in:Digestive diseases and sciences 2007-03, Vol.52 (3), p.732-736
Main Authors: REKHA CHERUVATTATH, ROSATI, Marianne J, GAUTAM, Manjushree, VARGAS, Hugo E, RAKELA, Jorge, BALAN, Vijayan
Format: Article
Language:English
Subjects:
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antiviral agents
Antiviral Agents - therapeutic use
Biological and medical sciences
Body mass index
Drug dosages
Drug Therapy, Combination
Female
Genotype & phenotype
Hepatitis C
Hepatitis C virus
Hepatitis C, Chronic - drug therapy
Human viral diseases
Humans
Infectious diseases
Interferon
Interferon-alpha - therapeutic use
Liver cirrhosis
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Polyethylene Glycols - therapeutic use
Recombinant Proteins
Retreatment
Retrospective Studies
Ribavirin - therapeutic use
Treatment Failure
Viral diseases
Viral hepatitis
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Summary:Currently, there are limited therapeutic options available for chronic hepatitis C (HCV) patients who fail treatment with peginterferon alpha (PEG IFN) + ribavirin (RBV). An option is retreatment with a second course PEG-IFN + RBV. However, the virologic clearance with this option is unknown. Thus, we evaluated the outcome of our cohort of patients with chronic HCV who achieved a sustained viral response when retreated with PEG IFN plus RBV after having no response to an initial course of PEG IFN plus RBV. Nonresponse to treatment was defined as failure to achieve an early virologic response by week 12 or presence of detectable HCV RNA at week 24 or after completion of PEG-IFN + RBV therapy. Twenty patients (12 [60%] men; 8 [40%] women) were treated with PEG IFN alpha-2b plus RBV and PEG IFN alpha-2a plus RBV. The mean age of the patients was 50 years, 85% were white, 95% had genotype 1, and 35% had cirrhosis. Prior to the first course of PEG IFN plus RBV, 12 (60%) of 20 patients had no prior treatment for Hepatitis C. After the second course of PEG IFN plus RBV, 2 (10%) of 20 patients achieved a sustained virologic response. These results suggest marginal benefit of retreatment of patients with chronic HCV with another course of PEG IFN plus RBV after they have not responded to an initial course of PEG IFN plus RBV.
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-006-9457-x