Response-guided therapy based on reaction to the initial dose using administration of peginterferon α-2a alone or in combination with ribavirin in naïve patients with chronic hepatitis C of serotype 2 and high viral loads

Abstract

Treatment with Peginterferon α-2a (PEG-IFNα2a) and α-2b (PEG-IFNα2b) was compared in naïve patients with chronic hepatitis C of serotype 2 and high viral loads (≥5 logIU/ml). In the PEG-IFNα2a group, PEG-IFNα2aα2a alone was administered for 24 weeks in patients negative for HCVRNA at week 4 (rapid viral response: RVR), while ribavirin (RBV) was added for patients who were still HCVRNA-positive at week 4 and given concomitantly with PEG-IFNα2a for further 24 weeks. In the PEG-IFNα2b group, RBV was administered concomitantly with PEG-IFNα2b for 24 weeks. The sustained virological response rates were 93.3% and 66.7% in the PEG-IFNα2a and PEG-IFNα2b groups, respectively, and PEG-IFNα2a alone or in combination with RBV gave similar results to PEG-IFNα2b+RBV. No patients in the PEG-IFNα2a group required discontinuation of administration due to adverse effects. Response-guided therapy based on RVR may be an effective and practical strategy with high efficacy, reduced costs, and fewer adverse events.