Clinical efficacy and safety of the combination therapy of peginterferon alpha and ribavirin in cirrhotic patients with HCV infection

doi:2010.16.1.38

Korean J Hepatol > Volume 16(1); 2010 > Article

The Korean Journal of Hepatology 2010;16(1): 38-48.
doi: https://doi.org/10.3350/kjhep.2010.16.1.38

Clinical efficacy and safety of the combination therapy of peginterferon alpha and ribavirin in cirrhotic patients with HCV infection

Hong Ryeol Cheong, M.D., Hyun Young Woo, M.D., Jeong Heo, M.D., Ki Tae Yoon, M.D., Dong Uk Kim, M.D., Gwang Ha Kim, M.D., Dae Hwan Kang, M.D., Geun Am Song, M.D., Mong Cho, M.D.

Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea

ABSTRACT

Background/Aims
The combination therapy of peginterferon (PEG-IFN) and ribavirin is the standard treatment for hepatitis C virus (HCV) infection. However, few trials have involved patients with cirrhosis. The purpose of this study was to elucidate the efficacy and safety of treatment with PEG-IFN and ribavirin in patients with cirrhosis associated with HCV infection. Method: A total of 65 patients were treated with PEG-IFN alpha-2a/ribavirin (n=32) or PEG-IFN alpha-2b/ribavirin (n=33). PEG-IFN alpha-2a and PEG-IFN alpha-2b were administered at doses of 180 μg/week and 1.5 μg/kg/week, respectively, and ribavirin was administered orally at doses of 800-1200 mg. Patients with HCV genotype 1 and genotype non-1 were treated for 48 and 24 weeks, respectively. The treatment response was assessed based on the sustained virologic response (SVR). Results: The early virologic response (EVR), end-of-treatment response (ETR), and SVR were 70.0%, 52.0%, and 24.0%, respectively, in genotype 1 (n=50). In genotype non-1 (n=15), the ETR was 53.3% and the SVR was 33.3%. The overall SVR did not differ with genotype (1vs non-1, 24.0%vs.33.3%; P=0.471) or between decompensated cirrhosis and compensated cirrhosis (20.0%vs.27.3%, P=0.630). Ten patients developed cirrhotic complications during the treatment, and 11 stopped treatment due to treatment -related adverse events. Conclusion: The combination therapy of PEG-IFN and ribavirin exhibited a low efficacy in cirrhotic patients with HCV infection and was associated with frequent serious complications. However, with careful management of complications, the therapy may have a considerable efficacy in some patients with cirrhosis and HCV infection. (Korean J Hepatol 2010;16:38-48

KeyWords: Chronic hepatitis C; Peginterferon; Ribavirin; Liver cirrhosis; Combination therapy