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Randomized Trial Evaluating the Impact of Ribavirin Mono-Therapy and Double Dosing on Viral Kinetics, Ribavirin Pharmacokinetics and Anemia in Hepatitis C Virus Genotype 1 Infection

Jesper Waldenström ; Johan Westin ; Kristina Nyström ; P. Christensen ; O. Dalgard ; M. Farkkila ; K. Lindahl ; Staffan Nilsson (Institutionen för matematiska vetenskaper, matematisk statistik) ; Gunnar Norkrans ; H. Krarup ; H. Norrgren ; M. R. Buhl ; S. Stenmark ; Martin Lagging
PLoS ONE (1932-6203). Vol. 11 (2016), 5, p. e0155142.
[Artikel, refereegranskad vetenskaplig]

In this pilot study (RibaC), 58 hepatitis C virus (HCV) genotype 1 infected treatment-naive patients were randomized to (i) 2 weeks ribavirin double dosing concomitant with pegylated interferon-alpha (pegIFN-alpha), (ii) 4 weeks ribavirin mono-therapy prior to adding pegIFN-alpha, or (iii) standard-of-care (SOC) ribavirin dosing concurrent with pegIFN-alpha. Four weeks of ribavirin mono-therapy resulted in a mean 0.46 log(10) IU/mL HCV RNA reduction differentially regulated across IL28B genotypes (0.89 vs. 0.21 log(10) IU/mL for CC and CT/TT respectively; P = 0.006), increased likelihood of undetectable HCV RNA week 4 after initiating pegIFN-alpha and thus shortened treatment duration (P < 0.05), and decreased median IP-10 concentration from 550 to 345 pg/mL (P < 0.001). Both experimental strategies impacted on ribavirin concentrations, and high levels were achieved after one week of double dosing. However, by day 14, double dosing entailed a greater hemoglobin decline as compared to SOC (2.2 vs. 1.4 g/dL; P = 0.03). Conclusion: Ribavirin down-regulates IP-10, and may have an antiviral effect differently regulated across IL28B genotypes.



Denna post skapades 2016-06-27. Senast ändrad 2016-07-06.
CPL Pubid: 238382

 

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Institutioner (Chalmers)

Institutionen för biomedicin, avdelningen för infektionssjukdomar (GU)
Institutionen för matematiska vetenskaper, matematisk statistik (2005-2016)

Ämnesområden

Infektionsmedicin

Chalmers infrastruktur