Background & AimsA combination of pegylated interferon alpha-2a (Peg-IFN-2a) and ribavirin (RBV) achieves a sustained virological response (SVR) in 40-50% of patients infected with genotype 1 hepatitis C virus (HCV), but efficacy rates are significantly lower in patients with decompensated HCV-induced cirrhosis. The efficacy and tolerability of Peg-IFN-2a and RBV, the cumulative dose effect, time to achieve planned cumulative dose and role of HCV phenotype on treatment response were determined in patients with decompensated HCV-induced cirrhosis.
MethodsIn this case-controlled study, 257 patients with decompensated HCV-induced cirrhosis were enrolled, including patients treated with partial splenic embolization for leukopaenia. Of patients with sufficient blood cell counts, 130 patients opted for antiviral therapy (treatment group) consisting of 180g/kg Peg-IFN-2a for 48weeks with 800-1200mg/day RBV; the remaining 127 were considered the control group. Primary endpoints were SVR and absence of relapse; the secondary end point was assessment of disease progression.
ResultsSustained virological response was highest and relapse rates were lowest when cumulative doses of Peg-IFN-2a and RBV were both 80% of the prescribed dose. Patients achieving 80% of the planned cumulative doses in 48weeks had a significantly higher SVR compared with patients achieving this in 72weeks. Patients with HCV genotype 1 had significantly lower SVR compared with patients with HCV genotype 2 (19.7% vs. 42.9%, respectively; P=0.008). Treatment group patients had a significantly lower rate of SVR-independent liver disease-related mortality.
ConclusionsOur findings provide additional evidence to support the use of Peg-IFN-2a and RBV therapy for decompensated HCV-induced cirrhosis.
[1]Jilin Univ, China Japan Union Hosp, Dept Digest, Changchun 130033, Jilin Province, Peoples R China.
(8.0+极速模式)