Pegylated interferon and ribavirin in HCV infected patients with normal blood tests

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Pegylated interferon and ribavirin in HCV infected patients with normal blood tests01/14/2005

There is little data on the effectiveness of pegylated interferon and ribavirin treatment for chronic hepatitis C infection in patients with normal blood tests, including tests of liver injury. A study in a recent issue of Gastroenterology evaluates whether patients with normal liver tests have a similar response to therapy as those with abnormal liver tests. The investigators studied nearly 500 patients with at least three normal blood tests for ALT, a marker of liver injury. Over 18 months, patients received either no treatment or weekly injections of pegylated interferon alfa and ribavirin for either 24 weeks (212 persons) or 48 weeks (210 persons). The investigators found that eradication of virus (known as sustained virological response, SVR) was 0% for the untreated group, 30% for the group receiving 24 weeks of treatment, and 52% for the group receiving 48 weeks of treatment. For patients with the more favorable genotype 2 or 3 virus, SVR was 72% for 24 weeks of treatment and 78% for 48 weeks of treatment. For genotype 1, which is more common in the US, 24 weeks of treatment resulted in an SVR of 13%, while the SVR was 40% for 48 weeks of treatment. Side effects were not different than what has been seen in previous studies of persons with elevated ALT. This study supports the concept that patients with normal ALT can benefit as much from treatment as people with abnormal blood tests. The numbers from the study clearly show that treatment is equally effective in patients with normal ALT results. Reference: Zeuzem S et al. Gastroenterology;127:1724-1732 (2004) http://www.veritasmedicine.com/d_home.cfm?type=WU & did=7 & cid=72576 & rfr=vp