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RBV Kinetics--Improves Early Response
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"Effects of ribavirin combined with interferon-alpha2b on viral kinetics during first 12 weeks of treatment in patients with hepatitis C virus genotype 1 and high baseline viral loads"
Journal of Viral Hepatitis
Volume 11 Issue 5, September 2004
M. Enomoto1, S. Nishiguchi1, M. Kohmoto1, A. Tamori1, D. Habu1, T. Takeda1, S. Seki1 and S. Shiomi2
1Department of Hepatology, Graduate School of Medicine, Osaka City University Medical School, Osaka; and 2Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University Medical School, Osaka, Japan
Summary
This study aimed to find how ribavirin increases viral disappearance in patients with hepatitis C virus (HCV) of genotype 1 and high baseline viral loads (>5.0 x105 copies/mL) when given with interferon (IFN).
Using the real-time quantitative polymerase chain reaction, we measured serum HCV in 20 patients during the first 12 weeks of therapy with IFN-alpha2b and ribavirin. Controls were 10 similar patients given IFN-alpha2b alone. IFN-alpha2b was given at 6 MU daily for 2 weeks, and then three times weekly. Ribavirin was given at 600 or 800 mg daily.
Serum HCV RNA decreased rapidly in the first phase, during the first 24 h of therapy (day 0), and more slowly in the early second phase (days 1-14). The median decrease was by 1.41 and 0.078 log 10/day in these two phases in the combination therapy group, and 0.90 and 0.081 log 10/day in the monotherapy group.
The difference between groups in the first phase was not significant (P = 0.24), nor was that in the next phase (P = 0.68). Later in the second phase, between days 14 and 84, the median decrease was larger in the combination therapy group (0.030 log 10/day) than in the monotherapy group (0.015 log 10/day, P = 0.035).
In patients with HCV genotype 1 and high viral loads, the effects of ribavirin with IFN-alpha appeared slowly, after the earliest days of treatment. A long-term favourable outcome of combination therapy may be associated with a rapid viral decline in this later phase of therapy.
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