title: Favorable factors for re-treatment with pegylated interferon α2a plus ribavirin in patients with high viral loads of genotype 1 hepatitis C virus.
abstract: OBJECTIVE
  Effect of re-treatment for pegylated interferon (PEG-IFN) plus ribavirin was not fully evaluated. We examined the effects of re-treatment with PEG-IFN plus ribavirin in patients with high viral loads of genotype 1 hepatitis C virus who failed to achieve a sustained virological response (SVR) with combination therapy.
  
  
  METHODS
  We examined 38 patients who were re-treated with PEG-IFN α2a plus ribavirin for more than 60 weeks, among whom 14 were non-responders and 24 were relapsers after previous treatment with PEG-IFN α2b plus ribavirin. IL28B genotyping was done in 21 patients.
  
  
  RESULTS
  The overall SVR rate was 34%. Analysis of baseline characteristics showed that the relapsers had a significantly higher SVR rate than the non-responders (50.0%, 12/24 vs. 7.1%, 1/14, respectively, P = 0.012) The SVR rates of re-treated patients who had turned hepatitis C virus (HCV) RNA-negative at weeks 8, 12, 24, and 48 of the previous therapy were 67% (4/6), 67% (4/6), 29% (2/7), and 25% (1/4), respectively. Re-treatment achieved an SVR in five of 12 patients with IL28B major alleles and three of nine patients with IL28B minor alleles. During the re-treatment, patients with complete viral suppression at week-12 achieved a significantly higher SVR rate (P = 0.001).
  
  
  CONCLUSIONS
  Re-treatment with PEG-IFN α2a plus ribavirin therapy is effective in patients who relapse after a course of PEG-IFN α2b plus ribavirin therapy. Re-treatment is a particularly useful option for patients who achieve early viral clearance during previous therapy.
authors.affiliation: Department of Hepatology, Osaka City University Graduate School of Medicine             Department of Hepatology Osaka City General Hospital             Department of Gastroenterology and Hepatology, Osaka City Juso Hospital, Osaka             Internal Medicine, Izumi Municipal Hospital, Izumi             Department of Virology & Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Tamori
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Kioka
authors.forename: Osamu
authors.initials: O
authors.lastname: Kurai
authors.forename: Hiroki
authors.initials: H
authors.lastname: Sakaguchi
authors.forename: Masaru
authors.initials: M
authors.lastname: Enomoto
authors.forename: Hideki
authors.initials: H
authors.lastname: Fujii
authors.forename: Sawako
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Shuji
authors.initials: S
authors.lastname: Iwai
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Morikawa
authors.forename: Seiko
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Kawasaki
authors.forename: Hiroko
authors.initials: H
authors.lastname: Oka
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Tanaka
authors.forename: Norifumi
authors.initials: N
authors.lastname: Kawada