title: Impact of ribavirin dose reduction on the efficacy of pegylated interferon plus ribavirin combination therapy for elderly patients infected with genotype 1b and high viral loads.
abstract: OBJECTIVE
  To examine the impact of ribavirin dose reduction on the efficacy of pegylated interferon (PEG IFN) plus ribavirin combination therapy for elderly patients infected with genotype 1b and high viral loads.
  
  
  METHODS
  A total of 72 patients, over 65 years old, were recruited for this study. Patients were divided into groups receiving either 600-800 mg of ribavirin according to bodyweight (Group 1, n = 36) or 400 mg of ribavirin (Group 2, n = 36) plus 1.5 µg/kg (range: 1.3-2.0 µg/kg) of PEG IFN-α-2b for 48 weeks.
  
  
  RESULTS
  Total ribavirin doses were administrated at 9.80 ± 2.39 mg/kg per day (3.29 ± 0.80 g/kg) for Group 1 and 5.87 ± 1.82 mg/kg per day (1.97 ± 0.61 g/kg) for Group 2 (P < 0.001). According to the total clearance (CL/F) of ribavirin, 34 of 36 patients in Group 1 received over-doses of ribavirin. In contrast, numbers of those receiving equivalent doses of ribavirin were two of 36 patients in Group 1 and 36 of 36 patients in Group 2, respectively (P < 0.001). End-of-treatment response (ETR) rates were observed in 23 of 36 patients (63.9%) in the standard ribavirin dose protocol and in 23 of 36 patients (63.9%) in the reduction ribavirin dose protocol (NS). Sustained virological response (SVR) rates were observed in 11 of 36 patients (30.6%) in the standard ribavirin dose protocol, and in 13 of 36 patients (36.1%) in the reduced ribavirin dose protocol (NS).
  
  
  CONCLUSIONS
  Reduction of ribavirin doses for elderly patients did not affect the outcome for the 48-week combination therapy.
authors.affiliation: Department of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure Department of Hepatology, Hiroshima Red Cross Hospital and Atomic Bomb Survivors Hospital Department of Gastroenterology, Hiroshima Prefectural Hospital Hiroshima IFN Study Group Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kohno
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Kouno
authors.forename: Shiomi
authors.initials: S
authors.lastname: Aimitsu
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Aisaka
authors.forename: Mikiya
authors.initials: M
authors.lastname: Kitamoto
authors.forename: Hiroiku
authors.initials: H
authors.lastname: Kawakami
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama