Significance of serum ribavirin concentration in combination therapy of interferon and ribavirin for chronic hepatitis C

被引:47
作者
Arase, Y
Ikeda, K
Tsubota, A
Suzuki, F
Suzuki, Y
Saitoh, S
Kobayashi, M
Akuta, N
Someya, T
Hosaka, T
Sezaki, H
Kobayashi, M
Kumada, H
机构
[1] Toranomon Gen Hosp, Dept Gastroenterol, Minato Ku, Tokyo 105, Japan
[2] Toranomon Gen Hosp, Hepat Res Unit, Minato Ku, Tokyo, Japan
关键词
chronic hepatitis C; interferon; ribavirin; urine PH; HCV-RNA;
D O I
10.1159/000081741
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
Objective: The purpose of this clinical retrospective cohort study was to determine the most suitable ribavirin concentration on combination therapy of interferon (IFN)-ribavirin. Methods: Entry criteria were serum HCV-RNA level >= 100 KIU/ml, HCV-genotype 1b, chronic hepatitis, and initial combination treatment of IFN-alpha-2b ( 6 million units daily for 2 weeks and then 3 times weekly for 6 weeks) and ribavirin ( 600 - 800 mg/day) for 8 weeks without stopping or decreasing the dosage of IFN and/or ribavirin. Sixty-eight consecutive patients who satisfied the above criteria were given maintenance therapy for another 16 weeks. Results: A sustained virological response (SVR) rate of 25.0% (17/68) was seen in all subjects. The SVR rate was 44.0% (11/25) in the high ribavirin group with a serum ribavirin concentration of >= 3,000 ng/ml at 8 weeks after initiation of combination therapy. SVR was significantly dependent at a serum ribavirin level of >= 3,000 ng/ml ( p = 0.005). The incidence of discontinuations and dose modifications for combination therapy in patients having a serum ribavirin concentration of >= 3,500 ng/ml 8 weeks after initiation of therapy was 57.1% (4/7). This value was statistically higher than that in patents with <3,500 ng/ml ( p = 0.033). Conclusion: Our results showed that the most suitable serum ribavirin concentrations are from 3,000 to 3,500 ng/ml 8 weeks after initiation of combination therapy. Copyright (C) 2005 S. Karger AG, Basel.
引用
收藏
页码:138 / 144
页数:7
相关论文
共 24 条
  • [11] Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial
    Manns, MP
    McHutchison, JG
    Gordon, SC
    Rustgi, VK
    Shiffman, M
    Reindollar, R
    Goodman, ZD
    Koury, K
    Ling, MH
    Albrecht, JK
    [J]. LANCET, 2001, 358 (9286) : 958 - 965
  • [12] The impact of interferon plus ribavirin on response to therapy in black patients with chronic hepatitis C
    McHutchison, JG
    Poynard, T
    Pianko, S
    Gordon, SC
    Reid, AE
    Dienstag, J
    Morgan, T
    Yao, RJ
    Albrecht, J
    [J]. GASTROENTEROLOGY, 2000, 119 (05) : 1317 - 1323
  • [13] Interferon alfa-2b alone or in combination with ribavirin as initial treatment for chronic hepatitis C
    McHutchison, JG
    Gordon, SC
    Schiff, ER
    Shiffman, ML
    Lee, WM
    Rustgi, VK
    Goodman, ZD
    Ling, MH
    Cort, S
    Albrecht, JK
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1998, 339 (21) : 1485 - 1492
  • [14] INVESTIGATION OF THE PATTERN OF HEPATITIS-C VIRUS SEQUENCE DIVERSITY IN DIFFERENT GEOGRAPHICAL REGIONS - IMPLICATIONS FOR VIRUS CLASSIFICATION
    MELLOR, J
    HOLMES, EC
    JARVIS, LM
    YAP, PL
    SIMMONDS, P
    CONRADIE, JD
    NEILL, AGN
    DUSHEIKO, GM
    KEW, MC
    KOSHY, A
    LIN, CK
    LAI, CL
    MURRAYLYON, I
    GUNAID, AA
    ELGUNEID, AM
    MUTIMER, D
    AHAMED, M
    NUCHPRAYOON, C
    TAMPRASERT, S
    PRESTON, FE
    CHUANSUMRIT, A
    MAHASANDANA, C
    PRITCHARD, DI
    RILEY, EM
    GREENWOOD, BM
    [J]. JOURNAL OF GENERAL VIROLOGY, 1995, 76 : 2493 - 2507
  • [15] RELATIONSHIP BETWEEN METABOLISM OF RIBAVIRIN AND ITS PROPOSED MECHANISM OF ACTION
    MILLER, JP
    KIGWANA, LJ
    STREETER, DG
    ROBINS, RK
    SIMON, LN
    ROBOZ, J
    [J]. ANNALS OF THE NEW YORK ACADEMY OF SCIENCES, 1977, 284 (MAR4) : 211 - 229
  • [16] Morrison R.T., 1992, ORGANIC CHEM
  • [17] Randomised trial of interferon α2b plus ribavirin for 48 weeks or for 24 weeks versus interferon α2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus
    Poynard, T
    Marcellin, P
    Lee, SS
    Niederau, C
    Minuk, GS
    Ideo, G
    Bain, V
    Heathcote, J
    Zeuzem, S
    Trepo, C
    Albrecht, J
    [J]. LANCET, 1998, 352 (9138) : 1426 - 1432
  • [18] Randomised, double-blind, placebo-controlled trial of interferon α-2b with and without ribavirin for chronic hepatitis C
    Reichard, O
    Norkrans, G
    Frydén, A
    Braconier, JH
    Sönnerborg, A
    Weiland, O
    [J]. LANCET, 1998, 351 (9096) : 83 - 87
  • [19] Ribavirin enhances the efficacy but not the adverse effects of interferon in chronic hepatitis C - Meta-analysis of individual patient data from European centers
    Schalm, SW
    Hansen, BE
    Chemello, L
    Bellobuono, A
    Brouwer, JT
    Weiland, O
    Cavalletto, L
    Schvarcz, R
    Ideo, G
    Alberti, A
    [J]. JOURNAL OF HEPATOLOGY, 1997, 26 (05) : 961 - 966
  • [20] Pharmacokinetics of ribavirin in combined interferon-alpha 2b and ribavirin therapy for chronic hepatitis C virus infection
    Tsubota, A
    Hirose, Y
    Izumi, N
    Kumada, H
    [J]. BRITISH JOURNAL OF CLINICAL PHARMACOLOGY, 2003, 55 (04) : 360 - 367