Dr Stefan Zeuzema and colleagues aimed to increase virologic response rates by individualized treatment according to the early virologic response.
The researchers frequently quantified serum Hepatitis C virus-RNA in 270 patients with chronic Hepatitis C.
The patients were treated with peginterferon alfa-2a 180 μg per week and ribavirin 1000-1200 mg per day.
|Virologic response occurred in 60% of the individualized arm vs 66% in the standard treatment|
|Journal of Hepatology|
The team classified patients after 6 weeks as rapid, slow, flat, or null responders.
The researchers subsequently randomized patients within each viral kinetic class to continue therapy either with an individualized or standard regimen.
Individualized therapy comprised peginterferon monotherapy of 48 weeks or a shorter combination therapy of 24 weeks for 171 rapid responders.
Triple therapy with histamine 1mg per day for 48 weeks or prolonged combination therapy of 72 weeks was given to 65 slow responders.
The researchers gave 10 flat responders triple therapy, and 22 null responders received high-dose peginterferon 360 μg per week plus ribavirin.
The team found that overall end-of-treatment and sustained virologic response rates were 77% in the individualized arm and 77% in the standard treatment arm.
The researchers noted that sustained virologic response was 60% in the individualized arm versus 66% in the standard treatment arm.
Histamine in addition to peginterferon and ribavirin did not improve virologic response rates in patients with flat response rates.
In addition, the team observed that high-dose peginterferon plus ribavirin did not improve virologic response rates in null responders.
Dr Zeuzema's team concludes, “An improvement in virologic efficacy was not achieved with the available individualized treatment options.”