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Ribavirin plasma concentration is a predictor of sustained virological response in patients treated for chronic hepatitis C virus genotype 2/3 infection
Department of Infectious Diseases, University of Southern Denmark, Odense C, Denmark; Department of Infectious Diseases, Herlev Hospital, Copenhagen, Denmark.
Department of Infectious Diseases, Göteborg University, Göteborg, Sweden.
Department of Infectious Diseases, Göteborg University, Göteborg, Sweden.
Department of Infectious Diseases, Haukeland University Hospital, Bergen, Norway; Institute of Medicine, University of Bergen, Bergen, Norway.
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2011 (English)In: Journal of Viral Hepatitis, ISSN 1352-0504, E-ISSN 1365-2893, Vol. 18, no 4, 245-51 p.Article in journal (Refereed) Published
Abstract [en]

In hepatitis C virus (HCV) genotype 1 infection, the likelihood of obtaining sustained virological response (SVR) is associated with higher ribavirin exposure. Such an association has not been demonstrated for HCV genotype 2/3 infection, where a fixed 800 mg daily dosing of ribavirin is generally recommended. The primary aim of this study was to investigate the correlation between ribavirin concentration at day 29 and therapeutic response in patients with HCV genotype 2/3 infection. A total of 382 patients were randomized to 12 or 24 weeks of treatment with pegylated interferon-alfa 2a 180 μg weekly and 800 mg ribavirin daily. Trough plasma concentration of ribavirin was measured at day 29 and week 12 and the primary outcome was SVR (HCV-RNA undetectable 24 weeks after treatment). Of the 382 patients, 355 had a ribavirin concentration available at day 29. SVR was 84% among patients with a ribavirin concentration ≥2 mg/L at day 29 compared to 66% in those with concentrations <2 mg/L (P = 0.002). The corresponding figures in the 12-week treatment group were 74% and 57% (P = 0.12), and in the 24-week treatment group 91% and 75% (P = 0.02), respectively. In a multivariate analysis, ribavirin concentration at day 29 was an independent predictor of SVR (P = 0.002). In conclusion, a higher plasma ribavirin concentration is associated with an increased likelihood of achieving SVR in HCV genotype 2/3 infection. Individualization of ribavirin dosing may be helpful in improving outcome, especially in the presence of unfavourable baseline characteristics. This, however, requires evaluation in a prospective trial.

Place, publisher, year, edition, pages
2011. Vol. 18, no 4, 245-51 p.
Keyword [en]
drug concentration, hepatitis C, ribavirin, treatment
National Category
Gastroenterology and Hepatology Infectious Medicine
Research subject
Infectious Diseases; Internal Medicine
Identifiers
URN: urn:nbn:se:oru:diva-37603DOI: 10.1111/j.1365-2893.2010.01303.xISI: 000288213200022PubMedID: 20384961Scopus ID: 2-s2.0-79952672318OAI: oai:DiVA.org:oru-37603DiVA: diva2:753518
Note

Funding Agenies:

Swedish Research CouncilSwedish Society of MedicineSwedish Society of MicrobiologyALF  ALFGBG-3149  Roche affiliates in the Nordic region  

"We thank the principal investigators at the centres in Sweden: Per Sangfelt, Rolf Hultcrantz, Lennart Englund, Christer Franzén, Rune Wejstål, Birgitta Arnholm, Anders Eilard, Jean Henrik Braconier, Ewa Wallmark, Ann-Sofi Duberg"

P. Brehm Christensen for the NORDynamicIC Study Group

Available from: 2014-10-08 Created: 2014-10-08 Last updated: 2017-10-18Bibliographically approved

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