Hepatogastroenterology

Abstract

BACKGROUND/AIMS: The current recommendation of ribavirin dose for the treatment of chronic hepatitis C is based on study results of Western patients, and might not be optimal for Korean patients because of different body frames. METHODOLOGY: A total of 163 treatment-naive genotype 1 chronic hepatitis C patients who received combination therapy with pegylated interferon a-2a and ribavirin were reviewed. RESULTS: Under current ribavirin dosing, only 49% of patients started therapy with ribavirin dose of 13-15mg/kg (targeted dose), while 45% and 6% of patients started therapy with ribavirin dose =16mg/kg and <13mg/kg, respectively. Patients who started therapy with higher ribavirin dose experienced more ribavirin dose modification during treatment (55%, 31% and 11% for ribavirin dose of =16mg/kg, 13-15mg/kg and <13mg/kg, respectively, p=0.002). The sustained virological response (SVR) rate was 66%, 63% and 56% for ribavirin dose of =16mg/kg, 13-15mg/kg and <13mg/kg, respectively (p=0.775). CONCLUSIONS: A certain proportion of Korean patients started therapy with a higher than targeted ribavirin dose, which resulted in more ribavirin dose modifications without definite additional benefit in achieving SVR. Therefore, the ribavirin dosing regimen might need to be reassessed.