title: The efficacy of extended treatment with pegylated interferon plus ribavirin in patients with HCV genotype 1 and slow virologic response in Japan.
abstract: BACKGROUND
  Which patients with hepatitis C virus (HCV) genotype 1 can benefit from extended treatment with pegylated interferon (Peg-IFN) plus ribavirin is unknown, although the overall sustained virologic response (SVR) rate has been shown to improve in patients with a late virologic response (LVR), defined as detectable serum HCV RNA at week 12 and undetectable at week 24.
  
  
  METHODS
  Among 1163 chronic hepatitis C patients with genotype 1 treated with Peg-IFN plus ribavirin combination therapy, 213 patients with an LVR were examined in this study. In addition, we selected 81 patients of matched sex and age from each of the 48- and 72-week treatment groups, using the propensity score, to compare the efficacy of the two treatment durations.
  
  
  RESULTS
  With 72-week treatment, the timing of HCV RNA disappearance and the hemoglobin level at baseline showed a strong correlation with the SVR on multivariate analysis. Earlier HCV RNA disappearance was associated with a better SVR rate, regardless of the ribavirin dose (HCV RNA disappearance at week 16, 74%; at week 20, 52%; and at week 24, 31%, p = 0.01). The SVR rate with 72-week treatment was higher than that with 48-week treatment, irrespective of age, sex, or the platelet value, and, especially in aged patients (≥65 years old), the SVR rate increased markedly with 72-week treatment (48 weeks, 25% vs. 72 weeks, 56%; p < 0.05).
  
  
  CONCLUSIONS
  An earlier response predicts a higher SVR rate in patients with an LVR given 72-week treatment. Extended treatment with Peg-IFN plus ribavirin for patients with an LVR improved the treatment efficacy, even for aged patients.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
authors.forename: Tsugiko
authors.initials: T
authors.lastname: Oze
authors.forename: Naoki
authors.initials: N
authors.lastname: Hiramatsu
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yakushijin
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Mochizuki
authors.forename: Kazuho
authors.initials: K
authors.lastname: Imanaka
authors.forename: Akira
authors.initials: A
authors.lastname: Yamada
authors.forename: Masahide
authors.initials: M
authors.lastname: Oshita
authors.forename: Akira
authors.initials: A
authors.lastname: Kaneko
authors.forename: Hideki
authors.initials: H
authors.lastname: Hagiwara
authors.forename: Eiji
authors.initials: E
authors.lastname: Mita
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ito
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Nagase
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Inui
authors.forename: Taizo
authors.initials: T
authors.lastname: Hijioka
authors.forename: Shinji
authors.initials: S
authors.lastname: Tamura
authors.forename: Harumasa
authors.initials: H
authors.lastname: Yoshihara
authors.forename: Eijiro
authors.initials: E
authors.lastname: Hayashi
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Imai
authors.forename: Michio
authors.initials: M
authors.lastname: Kato
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hosui
authors.forename: Takuya
authors.initials: T
authors.lastname: Miyagi
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Hisashi
authors.initials: H
authors.lastname: Ishida
authors.forename: Tomohide
authors.initials: T
authors.lastname: Tatsumi
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kiso
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Kanto
authors.forename: Akinori
authors.initials: A
authors.lastname: Kasahara
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Takehara
authors.forename: Norio
authors.initials: N
authors.lastname: Hayashi
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage; D016022:Case-Control Studies; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D006526:Hepatitis C / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D007564:Japan; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage*; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: 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