Abstract
Background & Aims: Patients with chronic hepatitis C and persistently normal alanine aminotransferase (ALT) levels have been routinely excluded from large randomized treatment trials; consequently, the efficacy and safety of antiviral therapy in this population are unknown. Methods: Patients with at least 3 normal ALT values over an 18-month period were randomized (3:3:1) to treatment with peginterferon alfa-2a 180 μg/wk plus ribavirin 800 mg/day for 24 weeks (212 patients), the same combination for 48 weeks (210 patients), or no treatment (69 patients) in a multinational study. All patients were monitored for 72 weeks. The primary measure of efficacy was sustained virologic response (SVR), defined as undetectable serum hepatitis C virus (HCV) RNA by qualitative polymerase chain reaction at the end of 24 weeks of untreated follow-up. Results: No patient cleared HCV RNA in the untreated control group. SVR rates of 30% and 52% were obtained in the 24- and 48-week treatment groups, respectively. In patients infected with HCV genotype 1, SVR rates of 13% and 40% were obtained with 24 and 48 weeks of treatment, respectively (P <. 0001). In patients infected with genotypes 2 or 3, SVR rates were 72% and 78% with 24 and 48 weeks of treatment, respectively (P =. 452). Treatment-related flares in ALT activity were not observed. Conclusions: The efficacy and safety of peginterferon alfa-2a and ribavirin combination therapy in patients with chronic hepatitis C and persistently normal ALT levels are similar to that in patients with elevated ALT levels. The indication for treatment of hepatitis C can be evaluated independently from baseline ALT activity.
| Original language | English |
|---|---|
| Pages (from-to) | 1724-1732 |
| Number of pages | 9 |
| Journal | Gastroenterology |
| Volume | 127 |
| Issue number | 6 |
| DOIs | |
| State | Published - Dec 1 2004 |
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ASJC Scopus subject areas
- Gastroenterology
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Peginterferon alfa-2a (40 kilodaltons) and ribavirin in patients with chronic hepatitis C and normal aminotransferase levels. / Zeuzem, Stefan; Diago, Moisés; Gane, Edward; Reddy, K. Rajender; Pockros, Paul; Prati, Daniele; Shiffman, Mitchell; Farci, Patrizia; Gitlin, Norman; O'Brien, Christopher B; Lamour, François; Lardelli, Pilar.
In: Gastroenterology, Vol. 127, No. 6, 01.12.2004, p. 1724-1732.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Peginterferon alfa-2a (40 kilodaltons) and ribavirin in patients with chronic hepatitis C and normal aminotransferase levels
AU - Zeuzem, Stefan
AU - Diago, Moisés
AU - Gane, Edward
AU - Reddy, K. Rajender
AU - Pockros, Paul
AU - Prati, Daniele
AU - Shiffman, Mitchell
AU - Farci, Patrizia
AU - Gitlin, Norman
AU - O'Brien, Christopher B
AU - Lamour, François
AU - Lardelli, Pilar
PY - 2004/12/1
Y1 - 2004/12/1
N2 - Background & Aims: Patients with chronic hepatitis C and persistently normal alanine aminotransferase (ALT) levels have been routinely excluded from large randomized treatment trials; consequently, the efficacy and safety of antiviral therapy in this population are unknown. Methods: Patients with at least 3 normal ALT values over an 18-month period were randomized (3:3:1) to treatment with peginterferon alfa-2a 180 μg/wk plus ribavirin 800 mg/day for 24 weeks (212 patients), the same combination for 48 weeks (210 patients), or no treatment (69 patients) in a multinational study. All patients were monitored for 72 weeks. The primary measure of efficacy was sustained virologic response (SVR), defined as undetectable serum hepatitis C virus (HCV) RNA by qualitative polymerase chain reaction at the end of 24 weeks of untreated follow-up. Results: No patient cleared HCV RNA in the untreated control group. SVR rates of 30% and 52% were obtained in the 24- and 48-week treatment groups, respectively. In patients infected with HCV genotype 1, SVR rates of 13% and 40% were obtained with 24 and 48 weeks of treatment, respectively (P <. 0001). In patients infected with genotypes 2 or 3, SVR rates were 72% and 78% with 24 and 48 weeks of treatment, respectively (P =. 452). Treatment-related flares in ALT activity were not observed. Conclusions: The efficacy and safety of peginterferon alfa-2a and ribavirin combination therapy in patients with chronic hepatitis C and persistently normal ALT levels are similar to that in patients with elevated ALT levels. The indication for treatment of hepatitis C can be evaluated independently from baseline ALT activity.
AB - Background & Aims: Patients with chronic hepatitis C and persistently normal alanine aminotransferase (ALT) levels have been routinely excluded from large randomized treatment trials; consequently, the efficacy and safety of antiviral therapy in this population are unknown. Methods: Patients with at least 3 normal ALT values over an 18-month period were randomized (3:3:1) to treatment with peginterferon alfa-2a 180 μg/wk plus ribavirin 800 mg/day for 24 weeks (212 patients), the same combination for 48 weeks (210 patients), or no treatment (69 patients) in a multinational study. All patients were monitored for 72 weeks. The primary measure of efficacy was sustained virologic response (SVR), defined as undetectable serum hepatitis C virus (HCV) RNA by qualitative polymerase chain reaction at the end of 24 weeks of untreated follow-up. Results: No patient cleared HCV RNA in the untreated control group. SVR rates of 30% and 52% were obtained in the 24- and 48-week treatment groups, respectively. In patients infected with HCV genotype 1, SVR rates of 13% and 40% were obtained with 24 and 48 weeks of treatment, respectively (P <. 0001). In patients infected with genotypes 2 or 3, SVR rates were 72% and 78% with 24 and 48 weeks of treatment, respectively (P =. 452). Treatment-related flares in ALT activity were not observed. Conclusions: The efficacy and safety of peginterferon alfa-2a and ribavirin combination therapy in patients with chronic hepatitis C and persistently normal ALT levels are similar to that in patients with elevated ALT levels. The indication for treatment of hepatitis C can be evaluated independently from baseline ALT activity.
UR - http://www.scopus.com/inward/record.url?scp=9644262441&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=9644262441&partnerID=8YFLogxK
U2 - 10.1053/j.gastro.2004.09.050
DO - 10.1053/j.gastro.2004.09.050
M3 - Article
C2 - 15578510
AN - SCOPUS:9644262441
VL - 127
SP - 1724
EP - 1732
JO - Gastroenterology
JF - Gastroenterology
SN - 0016-5085
IS - 6
ER -