Skip Navigation
Skip to contents

KMJ : Kosin Medical Journal

OPEN ACCESS
SEARCH
Search

Articles

Page Path
HOME > Kosin Med J > Volume 27(2); 2012 > Article
Original Article
The Combination Therapy with Peg-interferon Alfa and Ribavirin for Chronic Hepatitis C in Korea as an Initial Treatment
Dong Hyun Park, Sang Uk Lee, Jin Seok Yu, Jun Seop Lee, Hye Jung Kwon
Kosin Medical Journal 2012;27(2):111-118.
DOI: https://doi.org/10.7180/kmj.2012.27.2.111
Published online: December 27, 2012

Department of Internal Medicine, College of Medicine, Kosin University, Gospel Hospital, Busan, Korea.

Corresponding Author: Sang Uk Lee, Department of Internal Medicine, College of Medicine, Kosin University, 34 Amnam-dong, Seo-gu, Busan, 602-702, Korea. TEL: +82-51-990-6205, FAX: +82-51-990-3049, fk506@dreamwiz.com
• Received: March 16, 2012   • Revised: May 13, 2012   • Accepted: June 7, 2012

Copyright © 2012 Kosin University College of Medicine

  • 839 Views
  • 3 Download
  • Objectives
    The combination therapy with peginterferon and ribavirin has been used to treat chronic hepatitis C for several years in Korea but there is a few report about the results of the treatment. We evaluated safety and efficacy of the combination therapy with Peg-interferon and ribavirin and analyzed factors that may affect treatment.
  • Methods
    Total 72 untreated chronic hepatitis C patients were administered pegylated interferon alfa-2a (180µg/week) or alfa-2b (1.5µg/kg/week) and ribavirin (800 mg/day in genotype 2, 1000-1200 mg/day in genotype 1). Duration of the treatment was 24 weeks in genotype 2 and 48 weeks in genotype 1. Response of the treatment was evaluated by rapid virologic response (RVR), early virologic response (EVR), end treatment virologic response (ETR), sustained virologic response (SVR) and adverse event.
  • Results
    The RVR, EVR, ETR, SVR were 61.8%, 82.5%, 88.9% and 80.5% retrospectively. The SVR of genotype 1 was 63.4% and non-genotype 1 was 96.7%. Genotype (Odds ratio: 14.92) was an independent predictor of the SVR. Leukocytopenia, flu-like symptoms, itching, rash and anemia were common adverse events of the combination therapy and if then we reduced dose and there was one case of cessation.
  • Conclusions
    The combination therapy with Peg-interferon and ribavirin shows efficacy to the Korean patients with chronic hepatitis C as an initial treatment. Genotypes 2 and 3 were more likely to have a sustained virologic response.
  • 1. Global surveillance and control of hepatitis C. Report of a WHO consultation organized in collaboration with the Viral Hepatitis Prevention Board, Antwerp, Belgium. J Viral Hepat 1999;6:35–47.ArticlePubMed
  • 2. Lim YS. Current status of liver disease in Korea: hepatitis C. Korean J Hepatol 2009;15:S25–S28.ArticlePubMed
  • 3. Chung RT. Acute hepatitis C virus infection. Clin Infect Dis 2005;41:S14–S17.ArticlePubMed
  • 4. Seeff LB. Natural history of chronic hepatitis C. Hepatology 2002;36:S35–S46.ArticlePubMed
  • 5. Ishikawa T, Higuchi K, Kubota T, Seki K, Honma T, Yoshida T, et al. Combination PEG-IFN a-2b/Ribavirin therapy following treatment of hepatitis C virus-associated hepatocellular carcinoma is capable of improving hepatic functional reserve and survival. Hepatogastroenterology 2012;59:529–532.ArticlePubMed
  • 6. Poynard T, McHutchison J, Davis GL, Esteban-Mur R, Goodman Z, Bedossa P, et al. Impact of interferon alfa-2b and ribavirin on progression of liver fibrosis in patients with chronic hepatitis C. Hepatology 2000;32:1131–1137.ArticlePubMed
  • 7. Strader DB, Wright T, Thomas DL, Seeff LB. Diagnosis, management, and treatment of hepatitis C. Hepatology 2004;39:1147–1171.ArticlePubMed
  • 8. European Association for the Study of the Liver. EASL international consensus conference on hepatitis C. Paris, 26-28, February 1999, Consensus Statement. J Hepatol 1999;30:956–961.PubMed
  • 9. Lee HS, Lee JH, Choi MS, Kim CY. Comparison of the incidence of hepatocellular carcinoma in HBV-and HCV-associated liver cirrhosis; A prospective study. Korean J Hepatol 1996;2:21–28.
  • 10. Choo QL, Kuo G, Weiner AJ, Overby LR, Bradley DW, Houghton M. Isolation of a cDNA clone derived from a blood-born non-A, non-B viral hepatitis genome. Science 1989;244:359–362.PubMed
  • 11. Lee HJ, Suh JI, Park CW. Efficacy of treatment with interferon alpha in hepatitis C. Korean J Hepatol 1996;2:166–175.
  • 12. Yoon BC, Kim HJ, Kim KS, Yoo HD, Lee SU, Han BH. Therapeutic efficacy of combination therapy with Alpha Interferon and Ribavirin in chronic hepatitis C. Korean J Gastroenterol 2001;37:203–209.
  • 13. Suh DJ, Park NH, Chung YH, Lee YS. Efficacy of combination of Interferon α 2a , Ribavirin and UDCA in the treatment of chronic hepatitis C. Korean J Hepatol 1998;4:109–119.
  • 14. Choi WH, Paik SW, Choi MS, Lee JH, Koh KC, Yoo BC. Treatment of hepatitis C naive Patients according to EASL Recommendations in Korea. Korean J Hepatol 2003;9:S53.
  • 15. Manns MP, McHutchinson JG, Gordon SC, Rustgi VK, Shiffman M, Reindollar R, et al. Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Lancet 2001;358:958–965.ArticlePubMed
  • 16. Shepherd J, Brodin H, Cave C, Waugh N, Price A, Gabbay J. Pegylated interferon alpha-2a and -2b in combination with ribavirin in the treatment of chronic hepatitis C: a systematic review and economic evaluation. Health Technol Assess 2004;8:1–125.Article
  • 17. Itakura J, Asahina Y, Tamaki N, Hirayama I, Yasui Y, Tanaka T, et al. Changes in hepatitis C viral load during first 14 days can predict the undetectable time point of serum viral load by pegylated interferon and ribavirin therapy. Hepatol Res 2011;41:217–224.ArticlePubMed
  • 18. Mach TH, Cieśla A, Warunek W, Janas-Skulina U, Cibor D, Owczarek D, et al. Efficacy of pegylated interferon alfa-2a or alfa-2b in combination with ribavirin in the treatment of chronic hepatitis caused by hepatitis C virus genotype 1b. Pol Arch Med Wewn 2011;121:434–439.ArticlePubMed
  • 19. Zeuzem S, Feinman SV, Rasenack J, Heathcote EJ, Lai MY, Gane E, et al. Peginterferon alfa-2a in patients with chronic hepatitis C. N Engl J Med 2000;343:1666–1672.ArticlePubMed
  • 20. Sinn DH, Shin SR, Kil JS, Kim J, Gwak GY, Choi MS, et al. Efficacy of peg-interferon-a-2a plus ribavirin for patients aged 60 years and older with chronic hepatitis C in Korea. J Gastroenterol Hepatol 2011;26:469–476.ArticlePubMed
  • 21. Fried MW, Shiffman ML, Reddy KR, Smith C, Marinos G, Goncales FL Jr, et al. Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 2002;347:975–982.ArticlePubMed
  • 22. Lee H, Choi MS, Paik SW, Kim JH, Kim DY, Lee JH, et al. Peginterferon Alfa-2a plus Ribavirin for initial treatment of chronic hepatitis C in Korea. Korean J Hepatol 2006;12:31–40.PubMed
  • 23. Sinn DH, Paik SW, Kang P, Kil JS, Park SU, Lee SY, et al. Disease progression and the risk factor analysis for chronic hepatitis C. Liver Int 2008;28:1363–1369.ArticlePubMed
  • 24. Yu ML, Chuang WL. Treatment of chronic hepatitis C in Asia: when East meets West. J Gastroenterol Hepatol 2009;24:336–345.ArticlePubMed
  • 25. Jung YS, Park HB, Oak CH, Jang YK, Yun BC, Ahn SY, et al. The usefulness of histopathological severity index in predicting the response to Alpha-interferon in patients with chronic hepatitis C. Korean J Gastroenterol 1999;34:496–502.
  • 26. Chew KW, Allen SA, Taylor LE, Rich JD, Feller E. Treatment outcomes with Pegylated interferon and Ribavirin for male prisoners with chronic hepatitis C. J Clin Gastroenterol 2009;43:686–691.ArticlePubMedPMC
  • 27. Ferenci P, Brunner H, Laferl H, Scherzer TM, Maieron A, Strasser M, et al. A randomized, prospective trial of Ribavirin 400 mg/day versus 800 mg/day in combination with Peginterferon alfa-2a in hepatitis C virus genotypes 2 and 3. Hepatology 2008;47:1816–1823.ArticlePubMed
Fig. 1
Virologic response of pegylated interferon and ribavirin. RVR 61.8%, EVR 82.5%, ETR 88.9%, SVR 80.5%.
kmj-27-111-g001-l.jpg
Table 1
Baseline characteristics of study population
kmj-27-111-i001-l.jpg
Table 2
The SVR according to RVR, EVR, EVR
kmj-27-111-i002-l.jpg
Table 3
Odds ratio of several factors
kmj-27-111-i003-l.jpg
Table 4
Factors influencing on SVR from univariate analysis
kmj-27-111-i004-l.jpg
Table 5
Adverse events of therapy
kmj-27-111-i005-l.jpg

Figure & Data

References

    Citations

    Citations to this article as recorded by  

      • PubReader PubReader
      • ePub LinkePub Link
      • Cite
        CITE
        export Copy
        Close
      • Download Citation
        Download Citation
        Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

        Format:
        • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
        • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
        Include:
        • Citation for the content below
        The Combination Therapy with Peg-interferon Alfa and Ribavirin for Chronic Hepatitis C in Korea as an Initial Treatment
        Kosin Med J. 2012;27(2):111-118.   Published online December 27, 2012
        Close
      • XML DownloadXML Download
      Figure

      KMJ : Kosin Medical Journal