Analysis of the efficacy of treatment with peginterferon á-2a and ribavirin in patients coinfected with hepatitis B virus and hepatitis C virus

October 1, 2009

http://www3.interscience.wiley.com/journal/122501760/abstract

Liver International

Volume 29 Issue 10, Pages 1485 - 1493

Published Online: 7 Jul 2009

CLINICAL STUDIES

Analysis of the efficacy of treatment with peginterferon á-2a and ribavirin in

patients coinfected with hepatitis B virus and hepatitis C virus

Jian-Wu Yu 1 , Li-Jie Sun 1 , Yong-Hua Zhao 1 , Peng Kang 1 , Jie Gao 1 and

Shu-Chen Li 1

1 Department of Infectious Diseases, The Second Affiliated Hospital, Harbin

Medical University, Harbin, China

Correspondence

Dr Li-Jie Sun, Department of Infectious Diseases, The Second Affiliated

Hospital, Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin

150086, China

Tel: +86 451 866 05614

e-mail: lijiesun5234@...

Wiley & Sons A/S

ABSTRACT

Objective: To study the virological features of patients coinfected with

hepatitis B virus (HBV) and hepatitis C virus (HCV) and the efficacy of

combination therapy with peginterferon á-2a and ribavirin in these patients.

Methods: The epidemiological and virological data of 50 patients coinfected with

HBV and HCV were analysed. The virological response rates of patients treated

with peginterferon á-2a and ribavirin between the HBV and HCV coinfection group

and the HCV monoinfection group were compared.

Results: HCV-dominant virus strains accounted for 92.0% of the 50 coinfected

individuals, and HCV- and HBV-dominant virus strains accounted for the remaining

8.0%. The HBV DNA level of the patients coinfected with HBV and HCV was 4.6±0.9

log10 copies/ml, which was significantly lower than that in the HBV

monoinfection group (5.9±1.2 log10 copies/ml) (t=5.964, P<0.01). The

HBeAg-positive rate (12.0%, 6/50) of the coinfection group was significantly

lower than (45.3%, 19/42) that of the HBV monoinfection group (÷2=12.743,

P<0.01). The partial early virological response (pEVR) rate and the

end-of-treatment virological response (ETVR) rate (50.0%, 15/30; 90.0%, 27/30)

of patients with genotype 1 in the coinfection group were significantly higher

than those (16.0%, 4/25; 56.0%, 14/25) in the HCV monoinfection group (÷2=6.971,

P=0.008; ÷2=8.307, P=0.004). The relapse rate (55.6%, 15/27) of patients with

genotype 1 in the coinfection group was significantly higher than that (21.4%,

3/14) in the HCV monoinfection group (÷2=4.360, P=0.037). The sustained

virological response (SVR) rate (40.0%, 12/30) of patients with genotype 1 in

the coinfection group was compared with that of the HCV monoinfection group

(44.0%, 11/25) (÷2=0.090, P=0.765). There was no significant difference in the

on-treatment virological response, ETVR, SVR and relapse rates between two

groups for patients with genotype 2. The incidence of side effects (30%, 15/50)

of patients in the coinfection group was significantly higher than that (13%,

6/46) in the HCV monoinfection group (÷2=4.031, P=0.045). The reactivation rate

of HBV DNA (33.3%, 9/27) with HCV SVR was significantly higher than that of

patients without SVR (8.7%, 2/23) (÷2=4.393, P=0.036).

Conclusions: The replication of HBV was suppressed, and HCV was the dominant

virus strain. Compared with HCV-monoinfected patients, pEVR, ETVR and relapse

rates of patients with genotype 1 in the coinfection group were high, while they

shared similar SVR rates. HBV and HCV coinfection had no impact on the rate of

virological response for genotype 2.

--------------------------------------------------------------------------------

Received 20 April 2009

Accepted 8 June 2009

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1478-3231.2009.02080

October 1, 2009