Improved Sustained Virological Response Following Treatment with Pegylated-Interferon Alpha-2b Compared with Alpha-2a, Both with Ribavirin, for Chronic Hepatitis C Infection with Genotypes 2 and 3

Lindsay C. Mollison, Laurens Manning, Silvie Miczkova, Wendy Cheng

Hepatitis Services, Fremantle Hospital, Fremantle, Australia.
Royal Perth Hospital, Perth, Australia.
School of Medicine and Pharmacology, Fremantle Hospital, University of Western Australia, Crawley, Australia.
School of Medicine and Pharmacology, Fremantle Hospital, University of Western Australia, Crawley, Australia; Hepatitis Services, Fremantle Hospital, Fremantle, Australia.

DOI: 10.4236/ijcm.2014.53019                

Abstract

Purpose: The optimal formulation of pegylated interferon a (PEG-IFa) as a part of combination therapy with ribavirin (RBV) is uncertain for patients infected with hepatitis C Genotypes 2 and 3. Methods: A multivariate analysis of prospectively collected treatment data from two tertiary centres on 351 treatment na?ve HCV Genotype 2 or 3 patients who received PEG-IFa-2a or b plus ribavirin. Results: Univariate analyses demonstrate that PEG-IFa-2b based on regimens achieved a higher sustained virological response (SVR) than PEG-IFa-2a (77.9% versus 62.0%, P = 0.0012). On multivariate analyses, PEG-IFa-2b appeared superior to PEG-IFa-2a with an odds ratio (OR) and 95% confidence interval (CI₉₅) for SVR of 2.19 (CI₉₅ 1.35-3.52, P = 0.0005). Genotype was a significant predictor of outcome in the multivariate model with 80% of Genotype 2 but only 67.7% of Genotype 3 subjects achieving SVR (OR 2.66 [CI₉₅ 1.35-5.92]). Increasing age was negatively associated with SVR (OR 0.97 [CI₉₅ 0.94-0.99]). Some of the differences in SVR are explained by higher relapse rates with PEG-IFa-2a (P = 0.009). Conclusions: PEG-IFa-2b and RBV achieve higher SVR rates than PEG-IFa-2a and RBV in Genotypes 2 and 3 chronic HCV infections. There is less relapse with PEG-IFa-2b. Genotype 2 infections are considerably easier to cure. SVR is higher in younger patients. These findings should influence a choice of PEG-IFa in the era of direct acting anti-viral drugs in therapy of Genotypes 2 and 3.

Keywords

Hepatitis C; Pegylated Interferon; Ribavirin; SVR; Multivariate Analysis; Genotype 2; Genotype 3

Conflicts of Interest

The authors declare no conflicts of interest.

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