Korean J Gastroenterol.  2012 Nov;60(5):306-314. 10.4166/kjg.2012.60.5.306.

Efficacy of Peginterferon and Ribavirin Combination Therapy of Chronic Hepatitis C: A Pooled Analysis

Affiliations
  • 1Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea. 93cool@hanmail.net

Abstract

BACKGROUND/AIMS
A combination of peginterferon and ribavirin is the standard therapy for chronic hepatitis C (CHC). However, the respective study has not been carried out in a large scale in Korea. The purpose of this study was to collect the studies that have been reported in Korea in order to analyze the therapeutic effect of combination therapy and compare to find racial difference.
METHODS
Twenty-eight papers related to the therapeutic effect of combination therapy in CHC patients were analyzed based on pooled analysis.
RESULTS
Based on the analysis for genotype 1 in Korea, early virologic response (EVR), end of treatment response (ETR), and sustained virologic response (SVR) were 79.6% (125/157), 80.1% (166/207), and 62.7% (341/543). The EVR, ETR, and SVR for genotype 2 and 3 were 89.4% (119/133), 92.2% (203/220), and 84.1% (434/516). Data from other Asians showed that EVR and SVR for genotype 1 were 88.9% (290/326) and 64.4% (491/762) respectively and 88.8% (135/152), and 79.4% (151/190) for genotype 2 and 3 respectively. In Western, EVR and SVR for genotype 1 were 51.3% (1,981/3,860) and 42.4% (1,798/4,231) respectively, and for genotype 2 and 3 were 87.7% (350/399) and 77.8% (533/685) respectively. Based on the comparative analysis, no statistical difference in SVR between Koreans and other Asians (p=0.955) was observed; However, the SVR of Koreans was higher with significance than that of Westerns (p<0.001) On the other hand, there was no difference what so ever, in SVR for genotype 2 amongst the different races.
CONCLUSIONS
The SVR of combination therapy for the Korean chronic hepatitis C patients was similar to other Asians but higher than Westerns.

Keyword

Hepatitis C; Peginterferon; Ribavirin; Pooled analysis

MeSH Terms

Antiviral Agents/*therapeutic use
Databases, Factual
Drug Therapy, Combination
Genotype
Hepacivirus/genetics
Hepatitis C, Chronic/*drug therapy/ethnology
Humans
Interferon-alpha/*therapeutic use
Polyethylene Glycols/*therapeutic use
Recombinant Proteins/therapeutic use
Ribavirin/*therapeutic use
Treatment Outcome
Antiviral Agents
Interferon-alpha
Polyethylene Glycols
Recombinant Proteins
Ribavirin

Figure

  • Fig. 1 Flow diagram of enrolled patients. HIV, human immunodeficiency virus; HBV, hepatitis B virus; KT, kidney transplantation; ESRD, end stage renal disease; LC, liver cirrhosis; EVR, early virological response; SVR, sustained virological response.

  • Fig. 2 Virologic response rate according to genotype in Korean with chronic hepatitis C. Early virologic response (EVR) was achieved in 80% of patients and sustained virologic response (SVR) was achieved in 63% of patients with genotype 1. ETR, end of treatment response.

  • Fig. 3 Early virologic response (EVR) and sustained virologic response (SVR) according to the race in genotype 1 hepatitis C virus. EVR and SVR was significantly different between Korean and Caucasian with genotype 1 (80% vs. 51%, p<0.001; 64% vs. 42%, p<0.001). However, EVR and SVR was not significantly different between Korean and Asian with genotype 1 (80% vs. 88%, p=0.249; 64% vs. 63%, p=0.955).

  • Fig. 4 Early virologic response (EVR) and sustained virologic response (SVR) according to the race in genotype non-1 hepatitis C virus. EVR and SVR was not significantly different between Korean and Caucasian with genotype non-1 (90% vs. 88%, p=0.588; 84% vs. 78%, p=0.001).


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