Korean J Hepatol > Volume 15(4); 2009 > Article
The Korean Journal of Hepatology 2009;15(4): 496-503.
doi: https://doi.org/10.3350/kjhep.2009.15.4.496
A comparison of 24- vs. 48-week peginterferon plus ribavirin in patients with genotype 1 chronic hepatitis C
Mi Na Kim, M.D.1, Ki Tae Yoon, M.D.2,3, Jun Yong Park, M.D.1,3, Do Young Kim, M.D.1,3, Sang Hoon Ahn, M.D.1,3, Chae Yoon Chon, M.D.1,3, Kwang-Hyub Han, M.D.1,3
Department of Internal Medicine, 1Yonsei University College of Medicine, Seoul; 2Pusan University School of Medicine, Busan; 3Liver Cirrhosis Clinical Research Center, Seoul, Korea
The standard therapy for patients with genotype 1 chronic hepatitis C (CHC) is a combination of peginterferon and ribavirin for 48 weeks. However, the most appropriate duration of treatment remains to be established because of treatment-related side effects and cost. The aim of this study was to compare the efficacies of 24- and 48-week treatments, and to assess the efficacy of split 24-week therapy (a further 24 weeks of treatment in patients with relapse after the initial 24 weeks of treatment). Methods: A total of 130 patients with genotype 1 CHC was treated between June 2004 and December 2006. Patients with undetectable HCV RNA at 24 weeks of treatment (as assessed by qualitative PCR assay; n=101 patients) were allowed to choose either 24 or 48 weeks as the duration of their treatment; 51 patients chose the 24-week treatment regimen and the remainder chose the 48-week regimen. Patients who relapsed after 24 weeks of treatment were treated for further 24 weeks. The sustained virologic response (SVR) of each treatment group was analyzed. Results: The SVR rate was higher in patients treated for 48 weeks than in those treated for 24 weeks (74.0% vs. 52.9%, P=0.028). In the multivariate analysis, age < 50 years, platelets ≥ 150,000/mm3, and treatment duration for 48 weeks remained significant independent predictors of SVR. Fourteen of the 24 patients who relapsed in the 24-week treatment group received split 24-week therapy, and 6 patients (42.9%) achieved SVR. The overall SVR rate did not differ significantly between the 24-week treatment group, including those who underwent 24-week split therapy (64.7%), and the 48-week treatment group (64.7% vs. 74%, P=0.311). Conclusions: The 24-week plus additional split 24-week therapy following failure is a useful treatment strategy for patients with genotype 1 CHC. (Korean J Hepatol 2009;15:496-503)
KeyWords: Chronic hepatitis C; Genotype 1; Peginterferon; Ribavirin

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