By Liz Highleyman - www.hivandhepatitisc.com
Standard therapy for chronic hepatitis C virus (HCV) infection consists of 48 weeks of pegylated interferon (Pegasys or PegIntron) plus ribavirin for patients with hard-to-treat HCV genotypes 1 or 4, and 24 weeks for patients with genotypes 2 or 3. Little is known, however, about optimal treatment for HCV genotype 6, which is mainly seen in Southeast Asia and China.
To explore this issue, M.H. Nguyen from Stanford University and colleagues conducted a retrospective study of 190 consecutive Asian-American patients diagnosed with genotype 6 hepatitis C at a gastroenterology clinic in Northern California between 2001 and 2004. Results were reported in the May 2008 American Journal of Gastroenterology.
A subgroup of 66 previously treatment-naive patients completed 24 weeks of either conventional or pegylated interferon plus ribavirin, or else 48 weeks of pegylated interferon plus ribavirin. The primary outcome was sustained virological response (SVR), or undetectable HCV RNA 24 weeks after completion of therapy.
Results
There was no statistically significant difference in SVR rate between the 31 patients treated with 24 weeks of conventional interferon + ribavirin and the 23 patients treated with 24 weeks of pegylated interferon + ribavirin (51.6% vs 39%, respectively; P= 0.363).
However, the SVR rate for the 12 patients treated with 48 weeks of pegylated interferon + ribavirin was significantly higher than that of patients treated with the same regimen for only 24 weeks (75% vs. 39%; P= 0.044).
In conclusion, the study authors wrote, "Treatment-eligible patients with HCV genotype 6 should be treated with a full course of 48 [weeks] as tolerated. Larger prospective studies of patients with HCV genotype 6 are needed to confirm the optimal treatment duration with pegylated interferon + ribavirin."
6/13/08
ReferenceMH Nguyen, HN Trinh HN, R Garcia, and others. Higher rate of sustained virologic response in chronic hepatitis C genotype 6 treated with 48 weeks versus 24 weeks of peginterferon plus ribavirin. American Journal of Gastroenterology 103(5): 1131-1135. May 2008.
