title: Peginterferon alfa-2a plus ribavirin for the treatment of dual chronic infection with hepatitis B and C viruses.
abstract: 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.
authors.affiliation: National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chun-Jen
authors.initials: CJ
authors.lastname: Liu
authors.forename: Wan-Long
authors.initials: WL
authors.lastname: Chuang
authors.forename: Chuan-Mo
authors.initials: CM
authors.lastname: Lee
authors.forename: Ming-Lung
authors.initials: ML
authors.lastname: Yu
authors.forename: Sheng-Nan
authors.initials: SN
authors.lastname: Lu
authors.forename: Shun-Sheng
authors.initials: SS
authors.lastname: Wu
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Liao
authors.forename: Chi-Ling
authors.initials: CL
authors.lastname: Chen
authors.forename: Hsing-Tao
authors.initials: HT
authors.lastname: Kuo
authors.forename: You-Chen
authors.initials: YC
authors.lastname: Chao
authors.forename: Shui-Yi
authors.initials: SY
authors.lastname: Tung
authors.forename: Sien-Sing
authors.initials: SS
authors.lastname: Yang
authors.forename: Jia-Horng
authors.initials: JH
authors.lastname: Kao
authors.forename: Chen-Hua
authors.initials: CH
authors.lastname: Liu
authors.forename: Wei-Wen
authors.initials: WW
authors.lastname: Su
authors.forename: Chih-Lin
authors.initials: CL
authors.lastname: Lin
authors.forename: Yung-Ming
authors.initials: YM
authors.lastname: Jeng
authors.forename: Pei-Jer
authors.initials: PJ
authors.lastname: Chen
authors.forename: Ding-Shinn
authors.initials: DS
authors.lastname: Chen
mesh_terms: 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
chemical_list: 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