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Differential Antiviral Effects of Pegylated Interferon-α2a and Pegylated Interferon-α2b in Chronic Hepatitis C

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Abstract

Background and Objectives

Pegylated interferon (peg-IFN)-α2a and -α2b show different pharmacokinetic properties but are used interchangeably for hepatitis C treatment in traditional dual combinations and with newer agents. We assessed whether peg-IFN antiviral effects vary with peg-IFN subtype, affecting viral response in a differential manner.

Methods

Chronic hepatitis C patients treated with ribavirin combined with peg-IFN-α2a (N = 109) or -α2b (N = 114) were studied. Hepatitis C virus RNA quantitation was performed by Cobas TaqMan 5 min before treatment start and subsequently after 48/72 h and 7, 14, 28 and 90 days. Antiviral effect was assessed in terms of viraemia changes over treatment. Histology grading and staging, interleukin-28B (IL28B) status and baseline viral genotype, alanine aminotransferase, gamma glutamyltransferase and glucose were analysed.

Results

Viraemia decline after 48/72 h and 7 days was significantly greater with peg-IFN-α2b (1.96 and 2.12 vs 1.49 and 1.20 log10 IU/mL with peg-IFN-α2a; p < 0.001). Differences were of larger extent in patients with advanced fibrosis (p = 0.002), genotype 1 infection (p = 0.002) and CT/TT genotypes of IL28B (p = 0.001). A rebound in viral load was observed significantly more often after the first dose in patients treated with peg-IFN-α2b (78 vs 28 % in those with peg-IFN-α2a; p = 0.0001). Differences between peg-IFNs disappeared by day 28 of treatment.

Conclusion

There are significant pharmacodynamic differences between peg-IFN-α2a and -α2b in the early phase of chronic hepatitis C treatment. The greater early viral decline observed with peg-IFN-α2b was essentially confined to ‘difficult to treat’ patients. Whether this could affect response-guided treatment decision making, as well as triple drug regimens, needs to be assessed.

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Acknowledgments

This work was supported by the AORN V. Monaldi, Naples, Italy. EDM received sponsorship for participation in scientific meetings from Roche and Merck. The other authors have no conflict of interest to disclose.

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Authors and Affiliations

  1. Internal Medicine Section, Department of Cardiothoracic Sciences, University of Naples S.U.N., Ospedale Monaldi, Via Leonardo Bianchi snc, 80131, Naples, Italy

    Emanuele Durante-Mangoni, Antonio Parrella, Domenico Iossa, Roberto Andini, Rosa Molaro, Carminia Battimelli & Riccardo Utili

  2. Unit of Infectious and Transplant Medicine, A.O.R.N. dei Colli, Ospedale Monaldi, Via Leonardo Bianchi snc, 80131, Naples, Italy

    Emanuele Durante-Mangoni & Riccardo Utili

  3. Unit of Microbiology and Virology, A.O.R.N. dei Colli, Ospedale Monaldi, Via Leonardo Bianchi snc, 80131, Naples, Italy

    Giuseppe Sodano

Authors
  1. Emanuele Durante-Mangoni
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  2. Antonio Parrella
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  3. Domenico Iossa
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  8. Riccardo Utili
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Correspondence to Emanuele Durante-Mangoni.

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Durante-Mangoni, E., Parrella, A., Iossa, D. et al. Differential Antiviral Effects of Pegylated Interferon-α2a and Pegylated Interferon-α2b in Chronic Hepatitis C. Clin Drug Investig 34, 871–878 (2014). https://doi.org/10.1007/s40261-014-0241-y

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  • DOI: https://doi.org/10.1007/s40261-014-0241-y

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