Efficacy of Peginterferon Alfa-2a/Ribavirin Treatment in Chronic Hepatitis C Genotype 1 Improves When Used in Early Stages of Fibrosis
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Efficacy of Peginterferon Alfa-2a/Ribavirin Treatment in Chronic Hepatitis C Genotype 1 Improves When Used in Early Stages of Fibrosis

By Bruce Sylvester

CHICAGO, IL -- May 19, 2005 -- Hepatitis C genotype 1 patients with early-stage fibrosis achieved superior sustained virologic response (SVR) from treatment with peginterferon alfa-2a and ribavirin compared to patients with advanced fibrosis receiving the same combination therapy, researchers report.

"These findings suggest that hepatitis C genotype 1 patients with mild or no fibrosis should be seriously considered for early treatment with the combination therapy because progression of fibrosis appears to reduce SVR, and this risk should be avoided," said Paul Pockros, MD, clinical researcher, Scripps Clinic, La Jolla, California.

Dr. Pockros reported the findings here on May 15th at Digestive Diseases Week (DDW).

The investigators conducted a retrospective review of data from 328 subjects diagnosed with genotype 1 chronic hepatitis C virus (HCV) who were treated with peginterferon alfa-2a 180 mg/week plus ribavirin 1000/1200 mg/day for 48 weeks.

All subjects were participants in 2 registration trials. The cohort was 73% male and 84% Caucasian.

Patients had undergone a baseline liver biopsy, and were staged as no fibrosis (NoF), portal fibrosis (PF), incomplete septa (IS), or cirrhosis (CX).

Among the 241 patients with no fibrosis or portal fibrosis, the researchers observed a sustained viral response in 56% compared with 42% of 87 patients with incomplete septa or cirrhosis (P < .03).

The investigators observed no significant differences in outcomes related to gender, race, or baseline HCV RNA level.

Patients with no fibrosis or portal fibrosis were found to have superior sustained virologic response compared with patients with incomplete septa or cirrhosis.

"These patients should not defer therapy and wait for evidence of fibrosis progression, as this only reduces their chance for sustained virologic response," the authors concluded.

The study was sponsored by Roche Laboratories.

[Presentation title: Peginterferon Alfa-2a/ribavirin Treatment in Patients With Chronic HCV Genotype 1: Efficacy is Improved in Patients With Early Stages Of Fibrosis. Abstract S1568]

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