Response-guided therapy in Japanese chronic hepatitis C patients infected with genotype 1b and high viral load

Abstract

We investigated "Response-guided therapy" 48 weeks vs. 72 weeks in 250 Japanese chronic hepatitis C patients infected with genotype 1b and high viral load to peginterferon (Peg-IFN) α-2b plus ribavirin (RBV). SVR rate was 100% of patients with RVR. Although patients with cEVR did not significantly improve SVR rate with extended treatment to 72 weeks, patients with pEVR were significantly improved with extended treatment (8.0% vs. 59.6%, p<0.0001). In patients with non-RVR except for NVR, extended treatment to 72 weeks significantly improved SVR rate compared with 48-week treatment (57.8% vs. 72.4%, p=0.0413). Multivariate analysis identified low-density lipoprotein cholesterol (≥86 mg/dL), total dose of RBV per body weight (≥3 g/kg), cEVR, periods to the intial HCV-RNA negative to 20 weeks as significant determinants of SVR. When non-RVR cases with HCV-RNA reduction during 0-4 weeks less than 2 Log₁₀ IU/mL and that achieved LVR, total dose of RBV per body weight more than 3 g/kg and extended treatment to 72 weeks may increase SVR rate. Response-guided therapy is useful strategy in the treatment for chronic hepatitis C with genotype 1b and high viral load.