Improved Sustained Virological Response Following Treatment with Pegylated-Interferon Alpha-2b Compared with Alpha-2a, Both with Ribavirin, for Chronic Hepatitis C Infection with Genotypes 2 and 3 ()
Affiliation(s)
Hepatitis
Services, Fremantle Hospital, Fremantle, Australia.
Royal Perth Hospital, Perth, Australia.
School of Medicine and Pharmacology, Fremantle Hospital, University of Western Australia, Crawley, Australia.
School of Medicine and Pharmacology, Fremantle Hospital, University of Western Australia, Crawley, Australia; Hepatitis
Services, Fremantle Hospital, Fremantle, Australia.
ABSTRACT
Purpose: The optimal
formulation of pegylated interferon a (PEG-IFa) as a part of combination therapy with ribavirin
(RBV) is uncertain for patients infected with hepatitis C Genotypes 2 and 3. Methods:
A multivariate analysis of prospectively collected treatment data from two
tertiary centres on 351 treatment na?ve HCV Genotype 2 or 3 patients who
received PEG-IFa-2a or b plus ribavirin. Results: Univariate analyses demonstrate that PEG-IFa-2b based on regimens
achieved a higher sustained virological response (SVR) than PEG-IFa-2a (77.9% versus 62.0%, P = 0.0012). On multivariate
analyses, PEG-IFa-2b
appeared superior to PEG-IFa-2a with an
odds ratio (OR) and 95% confidence interval (CI95) for SVR of 2.19
(CI95 1.35-3.52, P = 0.0005). Genotype was a significant predictor
of outcome in the multivariate model with 80% of Genotype 2 but only 67.7% of Genotype
3 subjects achieving SVR (OR 2.66 [CI95 1.35-5.92]). Increasing
age was negatively associated with SVR (OR 0.97 [CI95 0.94-0.99]).
Some of the differences in SVR are explained by higher relapse rates with PEG-IFa-2a (P = 0.009). Conclusions: PEG-IFa-2b and RBV achieve
higher SVR rates than PEG-IFa-2a and RBV in Genotypes
2 and 3 chronic HCV infections. There is less relapse with PEG-IFa-2b. Genotype 2
infections are considerably easier to cure. SVR is higher in younger patients.
These findings should influence a choice of PEG-IFa in the era of direct
acting anti-viral drugs in therapy of Genotypes 2 and 3.
Share and Cite:
L. Mollison, L. Manning, S. Miczkova and W. Cheng, "Improved Sustained Virological Response Following Treatment with Pegylated-Interferon Alpha-2b Compared with Alpha-2a, Both with Ribavirin, for Chronic Hepatitis C Infection with Genotypes 2 and 3,"
International Journal of Clinical Medicine, Vol. 5 No. 3, 2014, pp. 111-117. doi:
10.4236/ijcm.2014.53019.
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