title: Prospective study of chronic hepatitis C treated with reduced initial ribavirin dose.
abstract: OBJECTIVE
  We prospectively examined the effects of a reduced initial dose of ribavirin (RBV) combined with pegylated interferon (Peg-IFN) to prevent RBV discontinuation due to adverse events in patients with chronic hepatitis C (CH-C) infection aged > 60y or with low hemoglobin values.
  
  
  METHODS
  We enrolled 42 patients with hepatitis C virus (HCV) serotype 1. Twenty-one of them with hemoglobin values < 14g/dl or who were aged > 60y comprised group A. The other 21 patients (sex-and age-matched with group A) comprised group B, and received Peg-IFN (1.5 microg/ kg/week) and RBV (10-13 mg/kg/day) for 48 weeks. Group A initially received 200 mg less RBV than group B.
  
  
  RESULTS
  Higher hemoglobin values persisted at 16, 20, 24 and 44 weeks, and the sustained viral response (SVR) ratio was lower in group A than in group B (17% vs. 57%). RBV therapy was discontinued due to severe anemia in group B, but not in group A.
  
  
  CONCLUSIONS
  The reduced initial dose of ribavirin prevented discontinuation due to anemia. However, this protocol cannot be recommended even for patients with CH-C accompanied by low hemoglobin or advanced age, since a sufficient SVR ratio is not achievable.
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime 791-0295, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Konishi
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hiasa
authors.forename: Takashi
authors.initials: T
authors.lastname: Nonaka
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hiraoka
authors.forename: Kouji
authors.initials: K
authors.lastname: Joko
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tokumoto
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
authors.forename: Bunzo
authors.initials: B
authors.lastname: Matsuura
authors.forename: Kojiro
authors.initials: K
authors.lastname: Michitaka
authors.forename: Norio
authors.initials: N
authors.lastname: Horiike
authors.forename: Morikazu
authors.initials: M
authors.lastname: Onji
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011446:Prospective Studies; D012367:RNA, Viral / Q000032:analysis; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage*
chemical_list: D000998:Antiviral Agents; D006454:Hemoglobins; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b