TITLE:
Improved Sustained Virological Response Following Treatment with Pegylated-Interferon Alpha-2b Compared with Alpha-2a, Both with Ribavirin, for Chronic Hepatitis C Infection with Genotypes 2 and 3
AUTHORS:
Lindsay C. Mollison, Laurens Manning, Silvie Miczkova, Wendy Cheng
KEYWORDS:
Hepatitis C; Pegylated Interferon; Ribavirin; SVR; Multivariate Analysis; Genotype 2; Genotype 3
JOURNAL NAME:
International Journal of Clinical Medicine,
Vol.5 No.3,
January
24,
2014
ABSTRACT: Purpose: The optimal
formulation of pegylated interferon a (PEG-IFa) as a part of combination therapy with ribavirin
(RBV) is uncertain for patients infected with hepatitis C Genotypes 2 and 3. Methods:
A multivariate analysis of prospectively collected treatment data from two
tertiary centres on 351 treatment na?ve HCV Genotype 2 or 3 patients who
received PEG-IFa-2a or b plus ribavirin. Results: Univariate analyses demonstrate that PEG-IFa-2b based on regimens
achieved a higher sustained virological response (SVR) than PEG-IFa-2a (77.9% versus 62.0%, P = 0.0012). On multivariate
analyses, PEG-IFa-2b
appeared superior to PEG-IFa-2a with an
odds ratio (OR) and 95% confidence interval (CI95) for SVR of 2.19
(CI95 1.35-3.52, P = 0.0005). Genotype was a significant predictor
of outcome in the multivariate model with 80% of Genotype 2 but only 67.7% of Genotype
3 subjects achieving SVR (OR 2.66 [CI95 1.35-5.92]). Increasing
age was negatively associated with SVR (OR 0.97 [CI95 0.94-0.99]).
Some of the differences in SVR are explained by higher relapse rates with PEG-IFa-2a (P = 0.009). Conclusions: PEG-IFa-2b and RBV achieve
higher SVR rates than PEG-IFa-2a and RBV in Genotypes
2 and 3 chronic HCV infections. There is less relapse with PEG-IFa-2b. Genotype 2
infections are considerably easier to cure. SVR is higher in younger patients.
These findings should influence a choice of PEG-IFa in the era of direct
acting anti-viral drugs in therapy of Genotypes 2 and 3.