Prolonged duration and dose of pegylated interferon and ribavirin after 48 weeks of treatment to maximinze SVR in HCV genotype 1-infected patients is recommended. In Taiwan, payment of treatment from National Health Insurance system is limited to 24 weeks therapy. We aimed to determine the feasibility of different courses of treatment with pegylated interferon plus ribavirin in patients infected with HCV genotype 1. From March 2003 to March 2008, 91 patients with HCV genotype 1 received pegylated interferon weekly as well as weigh-base ribavirin daily for either 24(n=33), 36(n=28) or 48(n=30) weeks. Normalization of ALT and sustained viral response 24 weeks after end of treatment were recorded and analyzed. Cost effectiveness and adverse drug effect were also recorded. Results: The end-of-follow-up response was 36.3% for 24 weeks treatment, 57.1% for 36 weeks treatment, and 63.3% for 48 weeks treatment. The rate of ALT normalization was 70% for 24 weeks, 82.1% for 36 weeks, and 76.7% for 48 weeks. Twenty-four weeks of therapy was inferior to 48 weeks in achievement of sustained viral response rates (p<0.05). There was no significant difference in the SVR rate between patients treated for 36 weeks and 48 weeks. We found an association between early fibrosis stage and therapy for more than 36 weeks with more durable treatment effects. Conclusion. The efficacies of 36 weeks pegylated interferon plus ribavirin treatment for patients infected with HCV genotype 1 is comparable to 48 weeks therapy. Larger studies are needed to elucidate the cost-effectiveness of these therapies.
Prolonged duration and dose of pegylated interferon and ribavirin after 48 weeks of treatment to maximinze SVR in HCV genotype 1-infected patients is recommended. In Taiwan, payment of treatment from National Health Insurance system is limited to 24 weeks therapy. We aimed to determine the feasibility of different courses of treatment with pegylated interferon plus ribavirin in patients infected with HCV genotype 1. From March 2003 to March 2008, 91 patients with HCV genotype 1 received pegylated interferon weekly as well as weigh-base ribavirin daily for either 24(n=33), 36(n=28) or 48(n=30) weeks. Normalization of ALT and sustained viral response 24 weeks after end of treatment were recorded and analyzed. Cost effectiveness and adverse drug effect were also recorded. Results: The end-of-follow-up response was 36.3% for 24 weeks treatment, 57.1% for 36 weeks treatment, and 63.3% for 48 weeks treatment. The rate of ALT normalization was 70% for 24 weeks, 82.1% for 36 weeks, and 76.7% for 48 weeks. Twenty-four weeks of therapy was inferior to 48 weeks in achievement of sustained viral response rates (p<0.05). There was no significant difference in the SVR rate between patients treated for 36 weeks and 48 weeks. We found an association between early fibrosis stage and therapy for more than 36 weeks with more durable treatment effects. Conclusion. The efficacies of 36 weeks pegylated interferon plus ribavirin treatment for patients infected with HCV genotype 1 is comparable to 48 weeks therapy. Larger studies are needed to elucidate the cost-effectiveness of these therapies.