Peginterferon Alfa-2a plus Ribavirin for Chronic Hepatitis C Virus Infection

• Published in: The New England journal of medicine Vol. 347; no. 13; pp. 975 - 982
• Main Authors: Fried, Michael W, Shiffman, Mitchell L, Reddy, K. Rajender, Smith, Coleman, Marinos, George, Gonçales, Fernando L, Häussinger, Dieter, Diago, Moises, Carosi, Giampiero, Dhumeaux, Daniel, Craxi, Antonio, Lin, Amy, Hoffman, Joseph, Yu, Jian
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 26.09.2002
• Subjects: Adult; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Antiviral Agents - adverse effects; Antiviral Agents - therapeutic use; Biological and medical sciences; Drug Therapy, Combination; Female; Genotype; Hepacivirus - drug effects; Hepacivirus - genetics; Hepacivirus - isolation & purification; Hepatitis; Hepatitis C, Chronic - drug therapy; Hepatitis C, Chronic - genetics; Hepatology; HIV; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Interferon; Interferon-alpha - adverse effects; Interferon-alpha - therapeutic use; Male; Medical sciences; Pharmacology. Drug treatments; Polyethylene Glycols - adverse effects; Polyethylene Glycols - therapeutic use; Recombinant Proteins; Ribavirin - adverse effects; Ribavirin - therapeutic use; RNA, Viral - blood; Viral diseases; Viral diseases of the digestive system; Human; Alpha interferon; Treatment efficiency; Cytokine; Tolerance; Hepatic disease; Ribavirin; Infection; Chronic; Viral disease; Immunotherapy; Digestive diseases; Antiviral; Clinical trial; Therapeutic protocol; Viral load; Viral hepatitis C
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa020047

Interferon-based therapies combined with ribavirin are effective for chronic hepatitis C, but many patients do not have a response and side effects are common. Pegylated interferons are more efficacious than standard interferons. In this large trial, peginterferon alfa-2a plus ribavirin resulted in a higher rate of sustained virologic response (56 percent) than interferon alfa-2b plus ribavirin (44 percent) and peginterferon alfa-2a alone (29 percent). Side effects occurred less often with peginterferon alfa-2a plus ribavirin than with interferon alfa-2b plus ribavirin. Peginterferon alfa-2a plus ribavirin appears to be better treatment than interferon alfa-2b plus ribavirin. Although the mechanism of action of ribavirin remains speculative, 1 the current standard of care for patients with chronic hepatitis C is the addition of ribavirin to interferon-based therapies. 2 – 7 Unfortunately, some patients, particularly those with more resistant hepatitis C virus (HCV) genotypes, do not respond to these agents. Two types of pegylated interferon, which differ in their pharmacokinetic and chemical properties, have been developed. Both have demonstrated significantly superior efficacy to non-pegylated interferons in several controlled clinical trials. 8 – 12 Peginterferon alfa-2b (a 12-kD linear polyethylene glycol moiety) plus ribavirin produced significantly improved sustained virologic responses as compared with interferon alfa-2b . . .