抄録
In recent years, combination therapy with IFNα-2b and ribavirin has become a standard treatment for chronic hepatitis C. However, combination with ribavirin often causes severe hemolytic anemia which reduces of the effect of therapy.
The total clearance of ribavirin (CL/F) calculated in consideration of sex, age, body weight and creatinine serum concentration is correlated with the serum concentration of ribavirin in the 4th week of therapy. In the present study, we evaluated the usefulness of CL/F based rivabirin dosages and to do this, analyzed the serum concentration of ribavirin and change in hemoglobin levels in both patients who received a CL/F based ribavirin dosage and patients who received a body weight based ribavirin dosage. Based on the CL/F based ribavirin dosage, the patients who received a body weight based ribavirin dosage were divided into an overdose group, an optimum dose group and a low dose group. In the optimum dose group, there was a significantly small change in the hemoglobin level and the rates for dose reduction and withdrawal of ribavirin were low, as compared with the overdose group. In both the optimum dose group and the CL/F based dosage group, most patients had a serum ribavirin concentration of 2000-2500 ng/mL in the 4th week of therapy, which has been advocated as a safe and effective serum concentration range for ribavirin.
In conclusion, our findings suggest that ribavirin dosage adjustment based on CL/F is useful for achieving safety and effectiveness in combination therapy with IFNα-2b and ribavirin.
