Brief Reports
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2005; 11(39): 6188-6192
Published online Oct 21, 2005. doi: 10.3748/wjg.v11.i39.6188
Treatment of genotype 2 and 3 chronic hepatitis C virus-infected patients
Perdita Wietzke-Braun, Volker Meier, Katrin Neubauer-Saile, Sabine Mihm, Giuliano Ramadori
Perdita Wietzke-Braun, Volker Meier, Katrin Neubauer-Saile, Sabine Mihm, Giuliano Ramadori, Abteilung fürGastroenterologie und Endokrinologie, Georg-August-Universität, Göttingen, Germany
Author contributions: All authors contributed equally to the work.
Correspondence to: Professor Dr. Giuliano. Ramadori, Abteilung für Gastroenterologie und Endokrinologie, Georg-August-Universität, Robert-Koch-Strasse 40, 37075 Göttingen, Germany. gramado@med.uni-goettingen.de
Telephone: +49-551-39-6301 Fax: +49-551-39-8596
Received: December 30, 2004
Revised: March 18, 2005
Accepted: March 21, 2005
Published online: October 21, 2005
Abstract

AIM: Before pegylated interferon alpha (IFN) was introduced for the therapy of chronic hepatitis C virus (HCV)-induced hepatitis, conventional thrice weekly IFN therapy was supplemented by ribavirin. Also, at that time, higher and more frequent doses of IFN were expected to be more effective than the standard regimen of 3 MU thrice weekly. As ribavirin significantly increases side effects and negatively influences the quality of life particularly in young patients, we started a prospective non-randomized study with a daily IFN-2a monotherapy as an initial treatment for chronic hepatitis C.

METHODS: Forty-six consecutive chronic HCV-infected patients received 3 MU IFN-2a per day as an initial treatment. Patients with genotype 2 or 3 (n = 12) were treated for 24 wk, and patients with genotypes other than 2 or 3 (n = 34) for 48 wk. Treatment outcome was followed up for 48 wk after the end of treatment (EOT). Virological response was defined as the absence of detectable serum HCV-RNA. Patients without virological response at 12 wk after the start of treatment received low-dose ribavirin (10 mg(kg·d)) additionally.

RESULTS: During treatment, three genotype 3 patients were excluded from the study due to incompliance. The remaining patients (n = 9) infected with genotype 2 or 3 showed an initial virological response rate of 100%. Six patients (66.7%) were still found to be virus-free at the end of follow-up period. In these patients, initial virological response was evident already after 2 wk of treatment. In contrast, initial virological response occurred first after 4 wk of treatment in the three patients who relapsed (33.3%). In comparison, patients infected with genotypes other than 2 or 3 (n = 34) showed an initial virological response rate of only 23.5% (n = 8), and even in combination with ribavirin a sustained virological response (SVR) rate of only 11.8% (n = 4) could be achieved.

CONCLUSION: In chronic HCV-infected patients with genotype 2 or 3, a SVR can be expected after 24 wk of daily dose IFN-2a treatment without ribavirin, if initial virological response develops early. This finding is worth to be confirmed in a prospective randomized study with pegylated IFN.

Keywords: Chronic hepatitis C virus infection; Genotype 2 and 3; Alpha interferon; Daily dose interferon therapy