title: A reduced dose of ribavirin does not influence the virologic response during pegylated interferon alpha-2b and ribavirin combination therapy in patients with genotype 1 chronic hepatitis C.
abstract: OBJECTIVE
  When combined with pegylated interferon alpha-2b (Peg-IFN α-2b) for the treatment of genotype 1 chronic hepatitis C (CHC) in Korea, the current guideline for the initial ribavirin (RBV) dose is based on body weight. However, since the mean body weight is lower for Korean patients than for patients in Western countries, current guidelines might result in Korean patients being overdosed with RBV.
  
  
  METHODS
  We retrospectively reviewed the medical records of patients with genotype 1 CHC who were treated with Peg-IFN α-2b and RBV combination therapy. We divided the patients into groups A (≥15 mg/kg/day, n=23) and B (<15 mg/kg/day, n=26), given that the standard dose is 15 mg/kg/day. The clinical course in terms of the virologic response, adverse events, and dose modification rate was compared between the two groups after therapy completion.
  
  
  RESULTS
  The early response rates (92.0% vs. 83.3%, P=0.634) and sustained virologic response rates (82.6% vs. 73.1%, P=0.506) did not differ significantly between the two groups. During the treatment period, the RBV dose reduction rate was significantly higher in group A than in group B (60.9% vs. 23.1%, P=0.01).
  
  
  CONCLUSIONS
  RBV dose reduction is performed frequently when patients are treated according to the current Korean guidelines. Given that lowering the RBV dose did not appear to decrease the virologic response during therapy, reducing RBV doses below the current Korean guideline may be effective for treatment, especially in low-weight patients.
authors.affiliation: Department of Internal Medicine, Soon Chun Hyang University Bucheon Hospital, Soon Chun Hyang University College of Medicine, Bucheon, Korea.
authors.forename: Byung Chul
authors.initials: BC
authors.lastname: You
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.forename: Hun il
authors.initials: Hi
authors.lastname: Kim
authors.forename: Se Hun
authors.initials: SH
authors.lastname: Kim
authors.forename: Seung Sik
authors.initials: SS
authors.lastname: Park
authors.forename: Yu Ri
authors.initials: YR
authors.lastname: Seo
authors.forename: Sang Gyune
authors.initials: SG
authors.lastname: Kim
authors.forename: Se Whan
authors.initials: SW
authors.lastname: Lee
authors.forename: Hong Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Soung Won
authors.initials: SW
authors.lastname: Jeong
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Boo Sung
authors.initials: BS
authors.lastname: Kim
mesh_terms: D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015992:Body Mass Index; D001835:Body Weight; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D011092:Polyethylene Glycols / Q000494:pharmacology / Q000627:therapeutic use*; D012367:RNA, Viral / Q000032:analysis; D011994:Recombinant Proteins / Q000494:pharmacology / Q000627:therapeutic use; D012189:Retrospective Studies; D012254:Ribavirin / Q000494:pharmacology / Q000627:therapeutic use*; D012737:Sex Factors; D016896:Treatment Outcome
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
keywords: Chronic hepatitis C; Koreans; Pegylated interferon alpha-2b; Ribavirin; Sustained virologic response