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Korean J Hepatol > Volume 16(2); 2010 > Article
The Korean Journal of Hepatology 2010;16(2): 201-205.
doi: https://doi.org/10.3350/kjhep.2010.16.2.201
The Korean Joumal of Peginterferon alfa-2a/ribavirin for 48 or 72 weeks in hepatitis C genotype 1 and 4 patients with slow virologic response
In Hee Kim, M.D.
Department of Internal Medicine, The Research Institute for Medical Science, Chonbuk National University Medical School, Jeonju, Korea

This randomized multicenter trial evaluated individualization of treatment duration with peginterferon alfa-2a 180 microg/wk plus ribavirin 1,000/1,200 mg/day in patients with chronic hepatitis C genotype 1/4 based on the rapidity of virologic response (VR).
Patients with arapid VR (RVR, undetectable hepatitis C virus [HCV]-RNA level (<50 IU/ml at week 4) were treated for 24 weeks, those with an early VR (EVR, no RVR but undetectable HCV-RNA level or >or= 2-log(10) decrease at week 12) were randomized to 48 (group A) or 72 weeks of treatment (group B, peginterferon alfa-2a was reduced to 135 microg/wkafter week 48). Patients without an EVR continued treatment until week 72 if they had undetectable HCV-RNA levels at week 24. The primary end point was relapse, sustained VR (SVR, undetectable HCV-RNA level after 24 weeks of follow-up evaluation) was a secondary end point.
Of 551 genotype 1/4 patients starting treatment, 289 were randomized to group A (N=139) or group B(N=150). The relapse rate was 33.6% in group A(95% confidence interval [CI], 24.8%-43.4%) and 18.5% in group B (95% CI, 11.9%-27.6%, P=0.0115 vs group A) and the SVR rate was 51.1% (95% CI,42.5%-59.6%) and 58.6% (95% CI, 50.3%-66.6%, P>0.1), respectively. The overall SVR rate was 50.4% (278 of 551, 95% CI, 46.2%-54.7%), including 115 of 150 patients with an RVR treated for 24 weeks and 4 of 78 patients without an EVR.
Extending therapy with peginterferon alfa-2a/ribavirin to 72 weeks decreases the probability of relapse in patients with an EVR. If they can be maintained on extended-duration therapy, SVR rates also may improve.
KeyWords: Hepatitis C virus; Peginterferon; Ribavirin; Slow virologic response
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