16-week Treatment May Be Adequate for Genotype 2 Hepatitis C Patients

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16-week Treatment May Be Adequate for Genotype 2 Hepatitis C Patients

Current hepatitis C virus (HCV) treatment guidelines call for 48

weeks of pegylated interferon plus ribavirin for patients with hard-

to-treat genotype 1 HCV, and 24 weeks for those with genotypes 2 or

3. However, for genotype 2 patients, a shorter course of therapy may

be sufficient, and would reduce the duration of side effects and the

cost of treatment.

As reported in the September 6, 2006 electronic edition of Gut,

researchers from Taiwan assessed whether a 16-week course of

treatment would be as effective as the standard 24-week course. In

their study, 150 genotype 2 patients were randomly assigned to

receive either 16 weeks (n = 50) or 24 weeks (n = 100) treatment with

180 mcg/week pegylated interferon alfa-2a (Pegasys) plus 1000-1200

mg/day ribavirin.

Results

86% of patients in the 16-week arm experienced rapid virological

response (RVR), defined as undetectable HCV RNA 4 weeks into

treatment, compared with 87% in the 24-week arm.

24 weeks after the completion of therapy, 94% of patients in the 16-

week arm and 95% in the 24-week arm achieved sustained virological

response (SVR).

Patients who experienced RVR were significantly more likely to

achieve SVR in both the 16-week arm (100% vs 57%; P = 0.015) and the

24-week arm (98% vs 77%; P = 0.002).

Multivariate analysis showed that RVR and age were independent

predictors of SVR.

Overall, treatment was equally well tolerated in both arms.

However, alopecia (hair loss) was significantly more common in the

24-week arm compared with the 16-week arm (49% vs 20%; P = 0.001).

Conclusion

In conclusion, the authors wrote, " 16-week and 24-week of

peginterferon with ribavirin at a dose of 1000-1200 mg/day provided

equal efficacy in HCV [genotype 2] patients who achieved a RVR at 4

weeks. "