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The efficacy of extended treatment with pegylated interferon plus ribavirin in patients with HCV genotype 1 and slow virologic response in Japan

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
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Abstract

Background

Which patients with hepatitis C virus (HCV) genotype 1 can benefit from extended treatment with pegylated interferon (Peg-IFN) plus ribavirin is unknown, although the overall sustained virologic response (SVR) rate has been shown to improve in patients with a late virologic response (LVR), defined as detectable serum HCV RNA at week 12 and undetectable at week 24.

Methods

Among 1163 chronic hepatitis C patients with genotype 1 treated with Peg-IFN plus ribavirin combination therapy, 213 patients with an LVR were examined in this study. In addition, we selected 81 patients of matched sex and age from each of the 48- and 72-week treatment groups, using the propensity score, to compare the efficacy of the two treatment durations.

Results

With 72-week treatment, the timing of HCV RNA disappearance and the hemoglobin level at baseline showed a strong correlation with the SVR on multivariate analysis. Earlier HCV RNA disappearance was associated with a better SVR rate, regardless of the ribavirin dose (HCV RNA disappearance at week 16, 74%; at week 20, 52%; and at week 24, 31%, p = 0.01). The SVR rate with 72-week treatment was higher than that with 48-week treatment, irrespective of age, sex, or the platelet value, and, especially in aged patients (≥65 years old), the SVR rate increased markedly with 72-week treatment (48 weeks, 25% vs. 72 weeks, 56%; p < 0.05).

Conclusions

An earlier response predicts a higher SVR rate in patients with an LVR given 72-week treatment. Extended treatment with Peg-IFN plus ribavirin for patients with an LVR improved the treatment efficacy, even for aged patients.

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Acknowledgments

Other institutions and participants in the Osaka Liver Forum are: Osaka General Medical Center, A Inoue; Higashiosaka City Central Hospital, S Iio; Itami City Hospital, Y Saji; Toyonaka Municipal Hospital, M Inada; Yao Municipal Hospital, H Fukui; Otemae Hospital, Y Doi; Osaka Medical Center for Cancer and Cardiovascular Diseases, K Katayama; Ashiya Municipal Hospital, T Kitada; National Hospital Organization Minami Wakayama Medical Center, K Fujimoto; Nishinomiya Municipal Central Hospital, H Ogawa; Saiseikai Senri Hospital, K Suzuki; Izumiotsu Municipal Hospital, S Yamagata; Osaka Kaisei Hospital, N Imaizumi; Kano General Hospital, S Kubota; Saso Hospital, M Nishiuchi; and Meiwa Hospital, Y Hayakawa. This work was supported by a Grant-in-Aid for Research on Hepatitis and BSE from the Ministry of Health, Labour and Welfare of Japan, and Scientific Research from the Ministry of Education, Science, and Culture of Japan. All authors have no financial relationships relevant to this study.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Tsugiko Oze, Naoki Hiramatsu, Takayuki Yakushijin, Kiyoshi Mochizuki, Atsushi Hosui, Takuya Miyagi, Yuichi Yoshida, Hisashi Ishida, Tomohide Tatsumi, Shinichi Kiso, Tatsuya Kanto, Akinori Kasahara & Tetsuo Takehara

  2. Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan

    Kazuho Imanaka

  3. Sumitomo Hospital, Osaka, Japan

    Akira Yamada

  4. Osaka Police Hospital, Osaka, Japan

    Masahide Oshita

  5. NTT West Osaka Hospital, Osaka, Japan

    Akira Kaneko

  6. Kansai Rousai Hospital, Amagasaki, Japan

    Hideki Hagiwara & Norio Hayashi

  7. National Hospital Organization Osaka National Hospital, Osaka, Japan

    Eiji Mita

  8. Osaka Koseinenkin Hospital, Osaka, Japan

    Toshifumi Ito

  9. Suita Municipal Hospital, Suita, Japan

    Toshihiko Nagase

  10. Hyogo Prefectural Nishinomiya Hospital, Nishinomiya, Japan

    Yoshiaki Inui

  11. National Hospital Organization Osaka Minami Medical Center, Kawachinagano, Japan

    Taizo Hijioka

  12. Minoh City Hospital, Minoh, Japan

    Shinji Tamura

  13. Osaka Rousai Hospital, Sakai, Japan

    Harumasa Yoshihara

  14. Kinki Central Hospital of Mutual Aid Association of Public School Teachers, Itami, Japan

    Eijiro Hayashi

  15. Ikeda Municipal Hospital, Ikeda, Japan

    Yasuharu Imai

  16. National Hospital Organization Minami Wakayama Medical Center, Tanabe, Japan

    Michio Kato

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  1. Tsugiko Oze
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  2. Naoki Hiramatsu
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Corresponding author

Correspondence to Naoki Hiramatsu.

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Oze, T., Hiramatsu, N., Yakushijin, T. et al. The efficacy of extended treatment with pegylated interferon plus ribavirin in patients with HCV genotype 1 and slow virologic response in Japan. J Gastroenterol 46, 944–952 (2011). https://doi.org/10.1007/s00535-011-0403-0

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  • DOI: https://doi.org/10.1007/s00535-011-0403-0

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