Plasma ribavirin trough concentrations during treatment of chronic hepatitis C in genotype-1 patients.

ABSTRACT

GOALS To investigate the correlation between virological response and plasma ribavirin trough concentrations (RBV Ctrough) during the full period of chronic hepatitis C (CHC) treatment. STUDY Multicenter prospective cohort study. Total 119 patients with CHC genotype-1 were treated with peginterferon alfa-2a (pegIFN) and RBV for 48 weeks. RBV quantification was carried out at week 4 (W4), W8, W12, W16, W24, W32, and W40 of treatment. RESULTS: The mean RBV Ctrough value during treatment was 2.5±0.9 mg/L in total patients. At no time point of treatment were patients with RBV Ctrough average correlated with early and sustained virological response (SVR), but those with RBV Ctrough ≥5 mg/L (95th percentile) at any time point (22/119, 18%) were correlated with SVR (P=0.02). Such high RBV Ctrough values were found from the second to the fourth months of treatment in 73% of these patients (16/22), and this was independently associated with SVR (odds ratio=3.6, 95% confidence interval1.02-13.2, P=0.04). CONCLUSION: Our data do not support RBV plasma monitoring as a tool to optimize treatment in patients with CHC genotype-1, but show that a high RBV plasma concentration could improve SVR rates.