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World J Gastroenterol. 2012 Jun 21;18(23):2966-72. doi: 10.3748/wjg.v18.i23.2966.

Impact of ribavirin dose on retreatment of chronic hepatitis C patients.

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  • 1Service d'Hépatologie and INSERM U773-CRB3, Hôpital Beaujon, University Paris-Diderot, 92110 Clichy, France.

Abstract

AIM:

To study the efficacy and factors associated with a sustained virological response (SVR) in chronic hepatitis C (CHC) relapsing patients.

METHODS:

Out of 1228 CHC patients treated with pegylated interferon (PEG-IFN) and ribavirin (RBV), 165 (13%) had a relapse. Among these, 62 patients were retreated with PEG-IFN-α2a or -α2b and RBV. Clinical, biological, virological and histological data were collected. Initial doses and treatment modifications were recorded. The efficacy of retreatment and predictive factors for SVR were analyzed.

RESULTS:

An SVR was achieved in 42% of patients. SVR was higher in young (< 50 years) (61%) than old patients (27%) (P = 0.007), and in genotype 2 or 3 (57%) than in genotype 1 or 4 (28%) patients (P = 0.023). Prolonging therapy for at least 24 wk more than the previous course was associated with higher SVR rates (53% vs 28%, P = 0.04). Also, a better SVR rate was observed with RBV dose/body weight > 15.2 mg/kg per day (70% vs 35%, P = 0.04). In logistic regression, predictors of a response were age (P = 0.018), genotype (P = 0.048) and initial RBV dose/body weight (P = 0.022). None of the patients without a complete early virological response achieved an SVR (negative predictive value = 100%).

CONCLUSION:

Retreatment with PEG-IFN/RBV is eff-ective in genotype 2 or 3 relapsers, especially in young patients. A high dose of RBV seems to be important for the retreatment response.

KEYWORDS:

Chronic hepatitis C; Pegylated interferon; Relapse; Retreatment; Ribavirin

PMID:
22736920
[PubMed - indexed for MEDLINE]
PMCID:
PMC3380324
Free PMC Article

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