Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2015; 21(6): 1994-1999
Published online Feb 14, 2015. doi: 10.3748/wjg.v21.i6.1994
Retreatment with peginterferon and ribavirin in chronic hepatitis C
Yong Min Jo, Sung Wook Lee, Sang Young Han, Yang Hyun Baek, Soo Young Kim, Woo Jae Kim, Ji Hye Ahn, Ji Young Lee
Yong Min Jo, Sung Wook Lee, Sang Young Han, Yang Hyun Baek, Soo Young Kim, Woo Jae Kim, Ji Hye Ahn, Ji Young Lee, Department of Internal Medicine, Dong-A University School of Medicine, Busan 602-715, South Korea
Author contributions: Jo YM and Lee SW performed the majority of the clinical practice and experiments; Han SY and Baek YH provided the patient medical records; Kim SY and Kim WJ contributed to the editing of the manuscript; Jo YM, Ahn JH and Lee JY designed the study and wrote the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Sung Wook Lee, MD, PhD, Department of Internal Medicine, Dong-A University School of Medicine, 3 Ga 1, Dongdaesin-dong, Seo-gu, Busan 602-715, South Korea. sunglee@dau.ac.kr
Telephone: +82-51-2405627 Fax: +82-51-2402087
Received: July 27, 2014
Peer-review started: July 27, 2014
First decision: August 15, 2014
Revised: October 27, 2014
Accepted: November 7, 2014
Article in press: November 11, 2014
Published online: February 14, 2015
Processing time: 199 Days and 3.2 Hours
Abstract

The development of boceprevir and telaprevir was a major step forward in the treatment of chronic hepatitis C. In addition, the treatment of these infections has been recently revolutionized by the approval of sofosbuvir and simeprevir. However, there are several challenges associated with the application of novel drugs, such as new and more frequent adverse events, new drug interactions, and excessively high treatment costs. An additional concern is viral resistance. These considerations highlight the fact that direct-acting antiviral agents are not a panacea and may not be the best option for all patients who are in need of therapy. This retrospective study revealed that the sustained virologic response was not significantly reduced following peginterferon and ribavirin retreatment compared with the new therapy. We suggest that patients who experience relapse shortly after completing treatment with peginterferon and ribavirin have a reasonable chance of achieving a sustained virologic response when retreated with these drugs alone.

Keywords: Chronic hepatitis C; Direct-acting antiviral agents; Peginterferon; Ribavirin; Retreatment

Core tip: Chronic hepatitis C-infected patients who experience relapse shortly after completing treatment with peginterferon and ribavirin have a reasonable chance of achieving a sustained virologic response when retreated with these drugs alone. Thus, it would be very reasonable to proceed with peginterferon and ribavirin retreatment alone, particularly in patients with factors associated with high rates of sustained virologic response, such as a low viral load at relapse (< 400000 IU/mL) and an early virologic response at week 12 of retreatment.