Response-guided therapy for patients with hepatitis C virus genotype 6 infection: a pilot study

• Published in: Journal of viral hepatitis Vol. 19; no. 6; pp. 423 - 430
• Main Authors: Tangkijvanich, P., Komolmit, P., Mahachai, V., Poovorawan, K., Akkarathamrongsin, S., Poovorawan, Y.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.06.2012
• Subjects: Adolescent; Adult; Aged; Antiviral Agents - administration & dosage; Drug Monitoring - methods; Female; Genotype; genotype 6; Hepacivirus - classification; Hepacivirus - genetics; Hepacivirus - isolation & purification; hepatitis C; Hepatitis C, Chronic - drug therapy; Hepatitis C, Chronic - virology; Humans; Interferon-alpha - administration & dosage; Male; Middle Aged; Polyethylene Glycols - administration & dosage; Recombinant Proteins - administration & dosage; Ribavirin - administration & dosage; RNA, Viral - blood; RVR; Time Factors; treatment duration; Treatment Outcome; Viral Load; virological response; Young Adult
• ISSN: 1352-0504; 1365-2893
• DOI: 10.1111/j.1365-2893.2011.01566.x

The optimal duration of treatment with pegylated interferon (PEG‐IFN) plus ribavirin (RBV) in patients with hepatitis C virus (HCV) genotype 6 is unknown. This study was aimed at determining treatment response on the basis of rapid virological response (RVR) of HCV genotype 6 in comparison with genotypes 1 and 3. Sixty‐six treatment naïve patients were treated with PEG‐IFN‐α2a (180 μg/week) plus weight‐based RBV (1000–1200 mg/day). Patients with genotype 1 n = 16) and genotype 3 (n = 16) were treated for a fixed duration of 48 and 24 weeks, respectively. Patients with genotype 6 (n = 34) who achieved RVR were treated for 24 weeks (response‐guided therapy) and the remaining patients were treated for 48 weeks (standard therapy). The mean baseline HCV RNA levels were not statistically different between groups (6.4 ± 0.8, 6.0 ± 1.0 and 6.5 ± 0.8 Log10 IU/mL for genotypes 1, 3 and 6, respectively). Patients with genotypes 1, 3 and 6 achieved RVR in 43.8%, 87.5% and 73.5% of cases, respectively. One patient with genotype 1 and 3 with genotype 6 were considered nonresponders and discontinued therapy. Sustained virological response (SVR) was achieved in 62.5%, 81.3% and 76.5% of patients with genotypes 1, 3 and 6, respectively. The SVR rate in patients with genotype 6 who underwent response‐guided therapy was 88%. This pilot study suggested that the SVR rate of HCV genotype 6 was at an intermediate level between those of genotypes 3 and 1. Treatment with PEG‐IFN plus RBV for 24 weeks may be sufficient for patients with genotype 6 who achieve RVR. Prospective randomized trials are required to evaluate this response‐guided strategy in a larger number of patients with genotype 6.