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Lead-in treatment with interferon-β/ribavirin may modify the early hepatitis C virus dynamics in pegylated interferon alpha-2b/ribavirin combination for chronic hepatitis C patients with the IL28B minor genotype

Authors


  • Atsukawa M and Tsubota A contributed equally to the preparation of this manuscript.
  • Conflict of interest: The authors declare that they have no conflict of interest.

Correspondence

Dr Masanori Atsukawa, Division of Gastroenterology, Department of Internal Medicine, Nippon Medical School Chiba Hokusoh Hospital 1715, Kamakari, Inzai, Chiba 270-1694, Japan. Email: momogachi@yahoo.co.jp

Abstract

Background and Aim

The most important factor influencing the effect of pegylated interferon (PEG-IFN)/ribavirin therapy (PEG) for chronic hepatitis C genotype 1b with high viral load is the interleukin 28B (IL28B) genotype. We investigated the usefulness of lead-in twice-daily interferon (IFN)-β/ribavirin therapy (IFN-β), and the early hepatitis C virus RNA (HCV-RNA) dynamics was compared between PEG and IFN-β groups according to the IL28B genotype.

Methods

Forty-six patients were randomly allocated to PEG and IFN-β groups, and HCV-RNA dynamics in an early phase of treatment were analyzed.

Results

The patients with minor IL28B genotype was 6/23 and 8/23 in IFN-β and PEG groups, respectively. In the patients with IL28B major genotype, viral load reduction was marginally greater in IFN-β group than in PEG group. In contrast, in the patients with the IL28B minor genotype, viral load reduction was significantly and numerically greater in IFN-β group than in PEG group at 1 week (2.07 vs 0.76 log IU/mL, P = 0.038), 2 weeks (2.73 vs 1.01, P = 0.009), 4 weeks (2.72 vs 1.55, P = 0.059), and 12 weeks (4.56 vs 3.24, P = 0.104). The sustained virological response rates in the IL28B major genotype were similar between IFN-β group (47.1%, 8/17) and PEG group (53.3%, 8/15). In contrast, the sustained virological response rates in the IL28B minor genotype were numerically higher in IFN-β group (50.0%, 3/6) than in PEG group (12.5%, 1/8), although not statistically significant.

Conclusion

It was suggested that lead-in twice-daily IFN-β/ribavirin treatment followed by PEG-IFN/ribavirin combination therapy may modify the HCV-RNA dynamics compared with that by PEG-IFN/ribavirin therapy, and it is particularly useful for the IL28B minor genotype.

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