Peginterferon alfa-2b plus ribavirin for treatment of chronic hepatitis C in previously untreated patients infected with HCV genotypes 2 or 3

Background/Aims: Treatment duration in patients with chronic hepatitis C in the era of standard interferon-alpha plus ribavirin was tailored according to hepatitis C virus (HCV) genotype: patients infected with HCV-1 were treated for 48 weeks, patients infected with HCV-2/3 for 24 weeks. The aim of the present study was to investigate this schedule for HCV-2/3 infected patients in the era of pegylated interferon-alpha plus ribavirin. Methods: Patients chronically infected with HCV-2 (n = 42) or HCV-3 (n = 182) were treated with peginterferon alfa-2b 1.5 mug/kg subcutaneously once weekly plus ribavirin 800-1400 mg/day based on body weight for 24 weeks. Results: The end of treatment (EOT) and sustained virologic response (SVR) was higher in patients infected with HCV-2 (100 and 93%, respectively) than in patients infected with HCV-3 (93 and 79%, respectively). Baseline viremia (P = 0.020), treatment duration > 16 weeks (P < 0.001) and steatosis (< 5 %, P = 0.015) were significant independent predictors of SVR. Adverse events resulted in discontinuation in 5% and dose reduction in 22% of patients. Conclusions: Treatment for 24 weeks with peginterferon alfa-2b and ribavirin is sufficient in HCV 2 or 3 infected patients. The lower SVR in patients infected with HCV-3 compared with HCV-2 infected patients may be related to higher levels of steatosis in this population. (C) 2004 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.