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

In: Recurrent hepatitis C

14 Sep 2012

PEG-IFN monotherapyTwo patients, who were switched to PEG-IFN monotherapy because of significant hemolysis on Rebetron, experienced a flare in their ALT levels after a change in their interferon. Patient 11 had his ALT level increase from 217 U/L to 439 U/L and he subsequently discontinued PEG-IFN after five weeks because of severe myalgias. The ALT level of patient 7 flared from 28 U/L to 567 U/L after switching to PEG-IFN. At this time, a liver biopsy demonstrated no acute cellular rejection (ACR) and reintroduction of small doses of ribavirin (200 mg to 400 mg) resulted in ALT level normalization.

Five patients had undetectable HCV-RNA while on PEG-IFN therapy. Patient 7, who had genotype 3 HCV and was HCV-RNA negative while on Rebetron for 10 months, subsequently became HCV-RNA positive again while on PEG-IFN and ribavirin combination therapy. A total of five patients were negative for HCV-RNA at the end of therapy, giving an ETR of 38.5%. SVR (HCV-RNA-negative by polymerase chain reaction six months after terminating therapy) was achieved in four of 13 (31%) patients. Two of these patients had genotype 2, one had genotype 1 and the other had genotype 6 (Table 4).

TABLE 4 Biochemical and virological responses to antiviral therapy

Patient ALT level at start (U/L) ALT level at finish (U/L) End of treatment response Sustainedvirologicalresponse HCVgenotype
1 305 20* Yes Yes 2
6 533 19* Yes Yes 2
4 102 19* Yes Yes 1
2 450 21* Yes Yes 6
7 347 67 No No 3
12 243 35* Yes* No 1
8 293 40* No No 1
5 70 25* No No 1
13 71 43* No No 4
3 157 46* No No 1
10 204 140 NP No 1
9 327 233 NP No 1
11 217 439 NP No 1
Average 247.6 88.2 5/13 (38.5%) 4/13 (30.8%)

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