Clinical

Shorter HCV treatment course suitable for some patients

Last Updated: 2005-06-23 9:40:18 -0400 (Reuters Health)

NEW YORK (Reuters Health) - A 12-week course of peginterferon and ribavirin is just as effective as a 24-week course for patients infected with hepatitis C virus (HCV) genotype 2 or 3 if HCV RNA is undetectable after 4 weeks of therapy, new research indicates. This is important because the risk of side effects is known to increase with treatment duration.

"Tailoring treatment so that those with an early response are given a shorter course may make therapy more appealing to patients, without adversely affecting outcomes," note lead author Dr. Alessandra Mangia, from Casa Sollievo della Sofferenza Hospital in San Giovanni Rotondo, Italy, and colleagues.

The findings stem from a study of 283 patients who were randomized to receive 24 weeks of peginterferon/ribavirin therapy or 12 to 24 weeks of the same regimen depending on whether HCV RNA was detectable or undetectable after 4 weeks of therapy.

The researchers' findings appear in the June 23rd issue of The New England Journal of Medicine.

The sustained virologic response rate in each group was nearly the same -- about 77%. In the overall analysis, the sustained virologic response rates for genotype 2 and 3 infections were 80% and 66%, respectively (p < 0.001).

The rate of relapse -- defined as undetectable HCV after treatment, but with reappearance 24 weeks after the end of follow-up -- in the variable-duration group was 8.9%, higher but not significantly different from the 3.6% rate seen in the standard-duration group.

As expected, side effects and treatment withdrawals were less common with the 12-week regimen than with the 24-week regimen.

The results suggest that the course of therapy can be shortened for HCV-infected patients, provided that an early treatment response is present, the authors conclude.

N Engl J Med 2005;352:2609-2617.