Peginterferon alfa-2a plus ribavirin for the treatment of dual chronic infection with hepatitis B and C viruses.
OBJECTIVE
Dual chronic infection with hepatitis C virus (HCV) and hepatitis B virus (HBV) is common in areas endemic for either virus. Combination therapy with ribavirin and pegylated interferon (peginterferon) is the standard of care for patients with HCV monoinfection. We investigated the effects of combination therapy in patients infected with both HBV and HCV (genotypes 1, 2, or 3).


METHODS
The study included 321 Taiwanese patients with active HCV infection; 161 also tested positive for hepatitis B surface antigen (HBsAg) and 160 were HBsAg-negative (controls). Patients with HCV genotype 1 infection received peginterferon alfa-2a (180 mug) weekly for 48 weeks and ribavirin (1000-1200 mg) daily. Patients with HCV genotypes 2 or 3 received peginterferon alfa-2a weekly for 24 weeks and ribavirin (800 mg) daily. At 24 weeks posttreatment, patient samples were examined for a sustained virologic response (SVR) against HCV (serum HCV levels decreased to <25 IU/mL).


RESULTS
In patients with HCV genotype 1 infection, the SVR was 72.2% in dually infected patients vs 77.3% in monoinfected patients after treatment. For patients with HCV genotype 2/3 infections, the SVR values were 82.8% and 84.0%, respectively, after treatment. Serum HBV DNA eventually appeared in 36.3% of 77 dual-infected patients with undetectable pretreatment levels of HBV DNA; this was not accompanied by significant hepatitis. Posttreatment HBsAg clearance was observed in 11.2% of 161 dual-infected patients.


CONCLUSIONS
Combination therapy with peginterferon alfa-2a and ribavirin is equally effective in patients with HCV monoinfection and in those with dual chronic HCV/HBV infection.
Liu
Chun-Jen
CJ
National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
Chuang
Wan-Long
WL
Lee
Chuan-Mo
CM
Yu
Ming-Lung
ML
Lu
Sheng-Nan
SN
Wu
Shun-Sheng
SS
Liao
Li-Ying
LY
Chen
Chi-Ling
CL
Kuo
Hsing-Tao
HT
Chao
You-Chen
YC
Tung
Shui-Yi
SY
Yang
Sien-Sing
SS
Kao
Jia-Horng
JH
Liu
Chen-Hua
CH
Su
Wei-Wen
WW
Lin
Chih-Lin
CL
Jeng
Yung-Ming
YM
Chen
Pei-Jer
PJ
Chen
Ding-Shinn
DS
D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004279:DNA, Viral / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus / Q000276:immunology; D006509:Hepatitis B / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D006515:Hepatitis B virus / Q000276:immunology; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use*; D013624:Taiwan; D016896:Treatment Outcome; D014762:Viral Interference / Q000502:physiology; D019562:Viral Load
D000914:Antibodies, Viral; D000998:Antiviral Agents; D004279:DNA, Viral; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a