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Shorter pegylated/interferon ribavirin regimen may effectively treat genotype 6 HCV

Pegylated interferon administered with ribavirin for 24 weeks may be as effective as a 48-week regimen in patients with genotype 6 chronic hepatitis C, according to study results.

In the open-label, randomized trial, 105 patients with HCV genotype 6 were randomly assigned to receive 180 mcg pegylated interferon (PEG-IFN) alfa-2a weekly and 15 mg/kg ribavirin daily for either 48 weeks (n=70) or 24 weeks (n=35) between January 2008 and December 2010. Evaluated factors included sustained virological response (SVR), rapid virological response (RVR) and potential predictors of response in both groups. Serum HCV-RNA levels were determined at baseline and during the fourth, 12th and 24th weeks of treatment, as well as at the end of treatment and 24 weeks following treatment.

SVR of the 48-week group was 71% out of 63 evaluable patients, compared with 60% out of 29 patients in the 24-week group, and this difference was not found statistically significant (P=.24). RVR was achieved by 81% of patients in the 48-week group and 80% in the 24-week group (P=.86). Among patients who achieved RVR, SVR occurred in 86% of the 48-week group and 75% of the 24-week group, compared with 8% of patients in the 48-week group who achieved SVR without RVR.

Independent predictors of SVR determined by the study included age in the 48-week group (P=.023) and age and AST/ALT ratio in the 24-week group (P=.049 and P=.034, respectively).

“While the largest study thus far, in genotype 6 patients, may not have been robustly powered to demonstrate non-inferiority of a shorter duration of treatment with PEG-IFN alfa-2a and weight-based RBV, 24 weeks and 48 weeks of treatment were equally effective,” the researchers wrote, adding that the results require validation from a larger study.