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PEGINTERFERON a-2b THERAPY IN ACUTE HEPATITIS C: IMPACT OF ONSET AND DURATION OF THERAPY ON SUSTAINED VIROLOGIC RESPONSE
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.....Earlier treatment (week 8 or 12) was associated with higher SVR particularly in genotype 1.....
S. Kamal 1'2's, Q. He I , A. A1 Tawil 2, K. Khalifa 2, S. Hakam 2, V~ Saleh 2,
M. Omar 2, J. Rasenack 3, M. Koziel 1 , M. Madwar 2 . :Haroard Institutes
of Medicine and Haroard Medical So.tool, Boston MA, USA," 2Ain Shams
Faculty of Medicine, Cairo, Egypt," 3University of Freiburg, Freiburg,
Germany
Background: The role, onset and duration of peginterferon treatment have not been evaluated in acute hepatitis C.
Objective: To assess the efficacy, safety, onset and duration of peginterferon-a, (PEG-IFN) in acute hepatitis C.
Methods: In this intent to treat study patients with acute HCV genotypes 1 and 4 (n = 98) were enrolled and prospectively followed. Patients were screened for 8 weeks after seroennversion or first positive PCR. Fifteen subjects refused treatment but were followed through the study. Patients without spontaneous recovery were randomized to begin PEG-IFN-a monotherapy at wks 8, 12, 20 respectively for either 12 or 24 weeks. A subset of subjects who failed to achieve a virologic response after 12 wks of treatment continued therapy for additional 12 wks.
Results: Five untreated subjects had spontaneous recovery and another 4 subjects scheduled to start treatment at weeks 12 or 20 resolved spontaneously before therapy. 79 subjects with persistent viremia were randomized to 3 groups (Table). The end of treatment response was 94% and the overall SVR was 82%. The SVR was better for genotype 4 compared to genotype 1. Earlier treatment (week 8 or 12) was associated with higher SVR particularly in genotype 1. Twelve week therapy was sufficient for genotype 4 while higher SVR rates in genotype 1 patients were achieved with 24 wks treatment (86%). Peginterferon c~-2b monotherapy was well tolerated and associated with significant improvement in the quality of life.
Conclusion: Peginterferon a-2b monothempy improves sustained virologic
response for acute hepatitis C virus with genotype 1 and 4 infection. Earlier treatment leads to increased virologic response. HCV genotype 1 may require longer treatment duration.
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