Pegylated-interferon alpha 2b and ribavirin for recurrent hepatitis C: Results (Part 1)

In: Recurrent hepatitis C

13 Sep 2012

The average starting dose of ribavirin was 660 mg per day in two daily divided doses (Table 3). The average duration of PEG-IFN treatment was 34.5 weeks (range two to 93 weeks). Six patients (46%) completed at least 48 weeks of antiviral treatment with PEG-IFN (and/or standard interferon) and ribavirin. Patient 12 was still HCV-RNA-positive by polymerase chain reaction after nine months of Rebetron and 48 weeks of PEG-IFN and ribavirin therapy. He remained on low doses of PEG-IFN and ribavirin as suppressive therapy for a total of 93 weeks.

The biochemical and virological responses to therapy will be shown further. The pretreatment ALT levels ranged from 70 U/L to 553 U/L (average 248 U/L). The average ALT level at the end of PEG-IFN therapy was 88 U/L. Nine patients (69%) had a biochemical response with a normal ALT level at the end of treatment. Despite the normal ALT level, four of these patients did not have a virological response after 48 weeks of treatment. Patient 12, who had cirrhosis, had a biochemical but not a virological response after 48 weeks of PEG-IFN and ribavirin therapy, but subsequently became HCV-RNA-negative after completing 93 weeks of PEG-IFN and ribavirin therapy. Because of a lack of funding, his treatment was then discontinued and within six weeks of terminating therapy, his ALT level flared to 598 U/L and HCV-RNA was again detectable.

TABLE 3 The starting and maximum doses of ribavirin achieved and the impact of therapy on hemoglobin (Hb) levels

Patient Ribavirin start (mg) Ribavirin max (mg) Ribavirin max (mg/kg) Hb start (g/L) Hb low (g/L) Drop in Hb (g/L)
11 0 0 0 131 131 0
7 200 400 5.3 118 113 5
10 400 400 5.2 111 81* 30
1t 400 600 8 147 116 31
2t 600 800 13.8* 132 80* 52§
6t 800 800 12.3* 124 108 16
4t 800 800 14.8* 145 112 33
13 800 800 8.6 137 93* 44
12 800 800 11* 152 99* 53
9 800 800 10.7* 153 144 9
8 800 1000 12.3* 138 75* 63
5 1000 1000 9.3 166 131 35
3 1200 1200 12.6* 130 88* 42
Average 662 723 9.53 137 105.5 34.4

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