Low-dose pegylated interferon-alpha-2a monotherapy in elderly and/or cirrhotic patients infected with hepatitis C virus genotype-2 or genotype-1 low level infection
Article first published online: 17 DEC 2012
© 2012 The Japan Society of Hepatology
Volume 43, Issue 7, pages 702–708, July 2013
How to Cite
Tamai, H., Moribata, K., Mori, Y., Shingaki, N., Deguchi, H., Ueda, K., Inoue, I., Maekita, T., Iguchi, M., Kato, J. and Ichinose, M. (2013), Low-dose pegylated interferon-alpha-2a monotherapy in elderly and/or cirrhotic patients infected with hepatitis C virus genotype-2 or genotype-1 low level infection. Hepatology Research, 43: 702–708. doi: 10.1111/hepr.12024
- Issue published online: 26 JUN 2013
- Article first published online: 17 DEC 2012
- Accepted manuscript online: 20 NOV 2012 08:15AM EST
- Manuscript Accepted: 11 NOV 2012
- Manuscript Revised: 9 NOV 2012
- Manuscript Received: 21 SEP 2012
- elderly patient;
- genotype 2;
- hepatitis C virus;
- low viral load;
- pegylated interferon-α-2a
Elderly and/or cirrhotic patients with hepatitis C virus (HCV) are at high risk of adverse effects during interferon therapy. The aim of the present study was to evaluate the efficacy, safety and predictive factors for sustained virological response (SVR) of low-dose pegylated interferon-α-2a (PEG IFN-α-2a) monotherapy in elderly and/or cirrhotic patients with HCV genotype-2 or genotype-1 low level infection.
Sixty-four elderly (≥65 years) and/or cirrhotic patients with HCV genotype-2 or genotype-1 low level (<5 logIU/mL) infection underwent low-dose PEG IFN-α-2a (90 μg/week) monotherapy for 24 weeks. Sixty patients were available for efficacy assessment.
SVR was achieved in 78.3%. SVR rates according to genotype-1 low, genotype-2 low and genotype-2 high viral load were 90.0%, 87.1% and 57.9%, respectively. The discontinuation rate was 12.5%. PEG IFN-α-2a was interrupted or discontinued in four patients because of severe thrombocytopenia (<25 000/mm3). The baseline platelet counts of all these patients were less than 70 000/mm3. On univariate analysis of factors contributing to SVR, significant differences were noted in viral load, platelet count, γ-glutamyltransferase, ferritin, α-fetoprotein level and rapid viral response (RVR). On multivariate analysis, RVR was the only independent factor (P = 0.010, odds ratio = 47.27). The positive and negative SVR-predictive values based on RVR were 95% and 82%, respectively.
Low-dose PEG IFN-α-2a monotherapy was effective and tolerable in elderly and/or cirrhotic patients with genotype-2 or genotype-1 low HCV level infection. However, a baseline platelet count of more than 70 000/mm3 is needed for safety. RVR can predict SVR accurately.