title: Pegylated interferon alfa and ribavirin for 14 versus 24 weeks in patients with hepatitis C virus genotype 2 or 3 and rapid virological response.
abstract: A recent nonrandomized pilot trial showed that hepatitis C virus (HCV) patients with genotype 2/3 and rapid virological response (RVR) had a 90% sustained virological response (SVR) rate after 14 weeks of treatment. We aimed to assess this concept in a randomized controlled trial. In the trial, 428 treatment-naïve HCV RNA-positive patients with genotype 2 or 3 were enrolled. Patients with RVR were randomized to 14 (group A) or 24 (group B) weeks of treatment. Patients were treated with pegylated interferon alpha-2b (1.5 microg/kg) subcutaneously weekly and ribavirin (800-1400 mg) orally daily. The noninferiority margin was set to be 10% between the two groups with a one-sided 2.5% significance level. RVR was obtained in 302 of 428 (71%), and 298 of these were randomized to group A (n = 148) or group B (n = 150). In the intention-to-treat analysis, SVR rates were 120 of 148 (81.1%) in group A and 136 of 150 (90.7%) in group B (difference, 9.6%; 95% confidence interval, 1.7-17.7). Among patients with an HCV RNA test 24 weeks after the end of treatment, 120 of 139 (86.3%) patients in group A achieved SVR compared with 136 of 146 (93.2%) in group B (difference, 6.9%; 95% confidence interval, -0.1 to +13.9).
  
  
  CONCLUSIONS
  We cannot formally claim that 14 weeks of treatment is noninferior to 24 weeks of treatment. However, the SVR rate after 14 weeks of treatment is high, and although longer treatment may give slightly better SVR, we believe economical savings and fewer side effects make it rational to treat patients with genotype 2 or 3 and RVR for only 14 weeks.
authors.affiliation: Infectious Disease Department, Ullevål University Hospital, Oslo, Norway. olav.dalgard@medisin.uio.no
authors.forename: Olav
authors.initials: O
authors.lastname: Dalgard
authors.forename: Kristian
authors.initials: K
authors.lastname: Bjøro
authors.forename: Helmer
authors.initials: H
authors.lastname: Ring-Larsen
authors.forename: Einar
authors.initials: E
authors.lastname: Bjornsson
authors.forename: Mona
authors.initials: M
authors.lastname: Holberg-Petersen
authors.forename: Eva
authors.initials: E
authors.lastname: Skovlund
authors.forename: Olle
authors.initials: O
authors.lastname: Reichard
authors.forename: Bjørn
authors.initials: B
authors.lastname: Myrvang
authors.forename: Bo
authors.initials: B
authors.lastname: Sundelöf
authors.forename: Ståle
authors.initials: S
authors.lastname: Ritland
authors.forename: Kjell
authors.initials: K
authors.lastname: Hellum
authors.forename: Aril
authors.initials: A
authors.lastname: Frydén
authors.forename: Jon
authors.initials: J
authors.lastname: Florholmen
authors.forename: Hans
authors.initials: H
authors.lastname: Verbaan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage* / Q000009:adverse effects / Q000191:economics; D019562:Viral Load / Q000706:statistics & numerical data
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b