Impact of ribavirin plasma level on sustained virological response in patients treated with pegylated interferon and ribavirin for chronic hepatitis C
Article first published online: 11 JUN 2009
© 2009 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 30, Issue 5, pages 487–494, September 2009
How to Cite
BREILH, D., FOUCHER, J., CASTÉRA, L., TRIMOULET, P., DJABAROUTI, S., MERROUCHE, W., COUZIGOU, P., SAUX, M.-C. and DE LÉDINGHEN, V. (2009), Impact of ribavirin plasma level on sustained virological response in patients treated with pegylated interferon and ribavirin for chronic hepatitis C. Alimentary Pharmacology & Therapeutics, 30: 487–494. doi: 10.1111/j.1365-2036.2009.04065.x
- Issue published online: 3 AUG 2009
- Article first published online: 11 JUN 2009
- Publication data Submitted 4 May 2009 First decision 27 May 2009 Resubmitted 29 May 2009 Accepted 9 June 2009 Epub Accepted Article 11 June 2009
Background The main goal of therapy in hepatitis C virus (HCV) infection is to achieve a sustained virological response (SVR). However, the impact of the pharmacological properties of ribavirin on the SVR has not been fully investigated.
Aim To evaluate, through a prospective study, the association between ribavirin plasma level and SVR response in HCV patients treated with pegylated interferon (PEG-IFN) and ribavirin.
Patients and methods Patients treated with PEG-IFN and ribavirin had plasmatic ribavirin dosage at weeks 4 and 12. SVR was evaluated 6 months after the end of treatment.
Results At week 4, a strong correlation was found between HCV-RNA and Cmin of ribavirin plasma level (r = −0.376, P = 0.002) and AUC012h of ribavirin plasma level (r = −0.277, P = 0.018). At week 12, a strong correlation was found between HCV-RNA and Cmin of ribavirin plasma level (r = −0.384, P < 0.0001) and AUC012h of ribavirin plasma level (r = −0.257, P = 0.002). In genotype 1 patients, AUC012h ribavirin and Cmin were significantly correlated with negative HCV-RNA at week 12 and SVR. In the multiple logistic regression model, the only factor independently associated with SVR in genotype 1 patients was negative HCV-RNA at week 12.
Conclusion Cmin of ribavirin at weeks 4 and 12 was significantly higher in sustained virological responders compared with relapser or nonresponder patients. However, in genotype 1 patients, plasma ribavirin level at weeks 4 and 2 was not associated with SVR.