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
Artikel i vetenskaplig tidskrift, 2016

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.

Författare

Jesper Waldenström

Göteborgs universitet

Johan Westin

Göteborgs universitet

Kristina Nyström

Göteborgs universitet

Peer B Christensen

Syddansk Universitet

O. Dalgard

Akershus University Hospital

Martti Färkkilä

Helsingin Yliopisto

K. Lindahl

Karolinska universitetssjukhuset

Staffan Nilsson

Chalmers, Matematiska vetenskaper, matematisk statistik

Göteborgs universitet

Gunnar Norkrans

Göteborgs universitet

H. Krarup

Aalborg Sygehus

H. Norrgren

Skånes universitetssjukhus

Mads Rauning Buhl

Aarhus Universitet

S. Stenmark

Martin Lagging

Göteborgs universitet

PLoS ONE

1932-6203 (ISSN)

Vol. 11 e0155142- e0155142

Ämneskategorier

Infektionsmedicin

DOI

10.1371/journal.pone.0155142