Impact of adherence to peginterferon-ribavirin combination therapy in chronic hepatitis C patients on achieving a sustained virologic response

doi:2009.15.3.338

Korean J Hepatol > Volume 15(3); 2009 > Article

The Korean Journal of Hepatology 2009;15(3): 338-349.
doi: https://doi.org/10.3350/kjhep.2009.15.3.338

Impact of adherence to peginterferon-ribavirin combination therapy in chronic hepatitis C patients on achieving a sustained virologic response

Soung Won Jeong, M.D., Jin Dong Kim, M.D.1, Hyun Young Woo, M.D.1, Chan Ran You, M.D.1, Sung Won Lee, M.D.1, Myeong Jun Song, M.D.1, Jung Won Jang, M.D.1, Si Hyun Bae, M.D.1, Jong Young Choi, M.D.1, Seung Kew Yoon, M.D.1

Department of Internal Medicine, College of Medicine, Soon Chun Hyang University; 1Department of Internal Medicine, College of Medicine, WHO collaborating Center on Viral Hepatitis, The Catholic University of Korea, Seoul, Korea

ABSTRACT

Background/Aims
Various predictive factors for peginterferon alpha and ribavirin therapy in chronic hepatitis C have been reported, but the effect of adherence to therapy has not been established. We investigated how adherence affects the sustained virologic response (SVR). Methods: We analyzed 92 chronic hepatitis C patients receiving peginterferon alpha and ribavirin combination therapy. Patients were first identified as having either genotype 1 or genotype non-1 infection and then categorized into three groups according to their adherence to the treatment protocol: (1) patients who received ≥80% of the recommended dosage of both peginterferon alpha and ribavirin for ≥80% of the intended duration of therapy, (2) patients who received <60% of the recommended dosage of both peginterferon alpha and ribavirin for <60% of the intended duration of therapy, and (3) patients who were not included in either group 1 or 2. Results: The rates of early virologic response, end of treatment response, and SVR differed significantly with the degree of adherence to the treatment. The SVRs of genotype 1 patients were 86.7%, 26.7%, and 66.7% in groups 1, 2, and 3, respectively (P=0.003), and those of genotype non-1 were 100%, 16.7%, and 88.9%, respectively (P<0.001). Conclusions: Adherence to therapy is a key factor in achieving an SVR. Supportive strategies to improve adherence will increase overall SVR rates. (Korean J Hepatol 2009;15:338-349)

KeyWords: Hepatitis C; Peginterferon alpha; Ribavirin; Medication adherence; Virologic response