Abstract
Background & Aims: The most effective therapy currently available for treatment of chronic hepatitis C virus (HCV) is the combination of peginterferon and ribavirin. This study evaluated the effectiveness of this treatment in patients who were nonresponders to previous interferon-based therapy. Methods: The first 604 patients enrolled in the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) Trial were evaluated. All were HCV RNA positive, previous nonresponders to interferon, with or without ribavirin, and had bridging fibrosis or cirrhosis on liver biopsy (Ishak fibrosis stage 3-6). Patients were retreated with peginterferon alfa-2a 180 μg/wk plus ribavirin 1000-1200 mg/day. Those with no detectable HCV RNA in serum at week 20 continued treatment for a total of 48 weeks and were then followed for an additional 24 weeks. Results: Thirty-five percent of patients had no detectable HCV RNA in serum at treatment week 20, and 18% achieved sustained virologic response (SVR). Factors associated with an SVR included previous treatment with interferon monotherapy, infection with genotypes 2 or 3, a lower AST: ALT ratio, and absence of cirrhosis. Reducing the dose of ribavirin from ≥80% to ≤60% of the starting dose during the first 20 weeks of treatment was associated with a decline in SVR from 21% to 11% (P ≤ 0.05). In contrast, reducing the dose of peginterferon or reducing ribavirin after week 20, when HCV RNA was already undetectable, did not significantly affect SVR. Conclusions: Selected nonresponders to previous interferon-based therapy can achieve SVR following retreatment with peginterferon alfa-2a and ribavirin.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1015-1023 |
| Number of pages | 9 |
| Journal | Gastroenterology |
| Volume | 126 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2004 |
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ASJC Scopus subject areas
- Gastroenterology
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Peginterferon Alfa-2a and Ribavirin in Patients with Chronic Hepatitis C Who Have Failed Prior Treatment. / Shiffman, Mitchell L.; Di Bisceglie, Adrian M.; Lindsay, Karen L.; Morishima, Chihiro; Wright, Elizabeth C.; Everson, Gregory T.; Lok, Anna S.; Morgan, Timothy R.; Bonkovsky, Herbert L.; Lee, William M.; Dienstag, Jules L.; Ghany, Marc G.; Goodman, Zachary D.; Everhart, James E.
In: Gastroenterology, Vol. 126, No. 4, 04.2004, p. 1015-1023.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Peginterferon Alfa-2a and Ribavirin in Patients with Chronic Hepatitis C Who Have Failed Prior Treatment
AU - Shiffman, Mitchell L.
AU - Di Bisceglie, Adrian M.
AU - Lindsay, Karen L.
AU - Morishima, Chihiro
AU - Wright, Elizabeth C.
AU - Everson, Gregory T.
AU - Lok, Anna S.
AU - Morgan, Timothy R.
AU - Bonkovsky, Herbert L.
AU - Lee, William M.
AU - Dienstag, Jules L.
AU - Ghany, Marc G.
AU - Goodman, Zachary D.
AU - Everhart, James E.
PY - 2004/4
Y1 - 2004/4
N2 - Background & Aims: The most effective therapy currently available for treatment of chronic hepatitis C virus (HCV) is the combination of peginterferon and ribavirin. This study evaluated the effectiveness of this treatment in patients who were nonresponders to previous interferon-based therapy. Methods: The first 604 patients enrolled in the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) Trial were evaluated. All were HCV RNA positive, previous nonresponders to interferon, with or without ribavirin, and had bridging fibrosis or cirrhosis on liver biopsy (Ishak fibrosis stage 3-6). Patients were retreated with peginterferon alfa-2a 180 μg/wk plus ribavirin 1000-1200 mg/day. Those with no detectable HCV RNA in serum at week 20 continued treatment for a total of 48 weeks and were then followed for an additional 24 weeks. Results: Thirty-five percent of patients had no detectable HCV RNA in serum at treatment week 20, and 18% achieved sustained virologic response (SVR). Factors associated with an SVR included previous treatment with interferon monotherapy, infection with genotypes 2 or 3, a lower AST: ALT ratio, and absence of cirrhosis. Reducing the dose of ribavirin from ≥80% to ≤60% of the starting dose during the first 20 weeks of treatment was associated with a decline in SVR from 21% to 11% (P ≤ 0.05). In contrast, reducing the dose of peginterferon or reducing ribavirin after week 20, when HCV RNA was already undetectable, did not significantly affect SVR. Conclusions: Selected nonresponders to previous interferon-based therapy can achieve SVR following retreatment with peginterferon alfa-2a and ribavirin.
AB - Background & Aims: The most effective therapy currently available for treatment of chronic hepatitis C virus (HCV) is the combination of peginterferon and ribavirin. This study evaluated the effectiveness of this treatment in patients who were nonresponders to previous interferon-based therapy. Methods: The first 604 patients enrolled in the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) Trial were evaluated. All were HCV RNA positive, previous nonresponders to interferon, with or without ribavirin, and had bridging fibrosis or cirrhosis on liver biopsy (Ishak fibrosis stage 3-6). Patients were retreated with peginterferon alfa-2a 180 μg/wk plus ribavirin 1000-1200 mg/day. Those with no detectable HCV RNA in serum at week 20 continued treatment for a total of 48 weeks and were then followed for an additional 24 weeks. Results: Thirty-five percent of patients had no detectable HCV RNA in serum at treatment week 20, and 18% achieved sustained virologic response (SVR). Factors associated with an SVR included previous treatment with interferon monotherapy, infection with genotypes 2 or 3, a lower AST: ALT ratio, and absence of cirrhosis. Reducing the dose of ribavirin from ≥80% to ≤60% of the starting dose during the first 20 weeks of treatment was associated with a decline in SVR from 21% to 11% (P ≤ 0.05). In contrast, reducing the dose of peginterferon or reducing ribavirin after week 20, when HCV RNA was already undetectable, did not significantly affect SVR. Conclusions: Selected nonresponders to previous interferon-based therapy can achieve SVR following retreatment with peginterferon alfa-2a and ribavirin.
UR - http://www.scopus.com/inward/record.url?scp=11144358311&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=11144358311&partnerID=8YFLogxK
U2 - 10.1053/j.gastro.2004.01.014
DO - 10.1053/j.gastro.2004.01.014
M3 - Article
C2 - 15057741
AN - SCOPUS:11144358311
VL - 126
SP - 1015
EP - 1023
JO - Gastroenterology
JF - Gastroenterology
SN - 0016-5085
IS - 4
ER -