A comparison of the exponential decay slope between PEG-IFN alfa-2b/ribavirin and IFN alfa-2b/ribavirin combination therapy in patients with chronic hepatitis C genotype 1b infection and a high viral load.
OBJECTIVE
A high virological response rate can often be shown to be obtained with PEG-IFN alpha-2b and ribavirin combination therapy in chronic hepatitis C patients. Viral dynamics have been utilized for the evaluation of antiviral effects, especially the exponential second decay slope, which represents the elimination of infected cells.


METHODS
Forty-nine patients were randomly assigned to the IFN alpha-2b group (n = 26) or the PEG-IFN alpha-2b group (n = 23). Ribavirin was administered equally to both groups. Measuring the serum concentration of HCVRNA, the exponential viral decay during phase 1 and 2 was calculated.


RESULTS
The exponential decay slope in phase 2 during the first 2 weeks was greater in the IFN alpha-2b group than in the PEG-IFN alpha-2b group; however, from weeks 3 to 4, it was greater in the PEG-IFN alpha-2b group than in the IFN alpha-2b group. Interestingly, in the PEG-IFN alpha-2b group, the exponential decay slope was greater from weeks 3 to 4 after initiating combination therapy than during the weeks 1-2 (p < 0.01), despite administration of the same PEG-IFN alpha-2b dose (1.5 microg/kg once weekly).


CONCLUSIONS
In PEG-IFN alpha-2b and ribavirin combination therapy, elimination of infected cells may be pronounced following an increase in serum ribavirin concentration in chronic hepatitis C patients with genotype 1b infection and a high viral load.
Izumi
Namiki
N
Division of Gastroenterology and Hepatology, Musashino Red-Cross Hospital, Tokyo, Japan. nizumi@musashino.jrc.or.jp
Asahina
Yasuhiro
Y
Kurosaki
Masayuki
M
Uchihara
Masakatsu
M
Nishimura
Yuki
Y
Inoue
Kazunari
K
Ueda
Ken
K
Tsuchiya
Kaoru
K
Hamano
Kousei
K
Itakura
Jun
J
Miyake
Shozo
S
D000328:Adult; D000998:Antiviral Agents / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012254:Ribavirin / Q000097:blood / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load; D014766:Viremia / Q000188:drug therapy
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a