Five years experience of pegylated interferon (PEG-IFN) plus Ribavirin (RBV) therapy in chronic hepatitis C

Introduction: PEG-IFN combined with RBV is currently regarded as the best antiviral treatment for chronic hepatitis C (CHC). Aim: To survey our experience with this treatment modality between 2004 and 2009. Patients and methods: The pts were treated for 12 months with once-weekly injections of PEG-IFN combined with 1.0–1.2g RBV daily. To date, 222 pts were enrolled in this course of therapy and the 6 months follow-up period. One hundred and fifty-five (70%) had not participated in previous IFN treatment (88 women, 67 men, age range (17–65 years, mean: 46.8 +/- 9.7), bodyweight 40–120kg (mean: 75.4 +/- 15.0). Sixty-seven (30%) had taken part in various previous treatment modalities, which had proved unsuccessful, e.g. IFN monotherapy, PEG-IFN monotherapy, standard IFN + RBV therapy or PEG-IFN + RBV therapy (36 women, 31 men, age range (23–63 years, mean: 46.8 +/- 9.7), bodyweight 40–120kg (mean: 75.4 +/- 15.0). Of the 155 treatment-naive pts, 115 (74.2%) completed the course of therapy, while 40 (25.8%) dropped out because of the “stopping rule“ (25), the spontaneous cessation of therapy (3) or various adverse events (12), such as septic infections, photosensitivity, hyperthyroidism, psychiatric disorders or cytopenias. Results: Among the treatment-naive 155 pts, 69 pts (44.5%) displayed a sustained virological response (SVR). On the other hand, there was a SVR in only 15 of the 67 previously unsuccessfully treated pts (22.4%). A PEG-IFN dose reduction was necessary in 19 treatment-naive pts because of neutropenia or thrombopenia, and a RBV dose reduction was needed in 44 treatment-naive pts because of anemia, as compared with 4 and 11, respectively, in the previously unsuccessfully treated group. Conclusions: This survey of our data demonstrates that this treatment modality with PEG-IFN + RBV may be effective in around half of treatment-naive CHC pts and in a somewhat smaller proportion of previously unsuccessfully treated CHC pts. The side-effects are mostly tolerable. An RBV dose reduction was necessary more often than in the case of PEG-IFN.