Four-week pegylated interferon alpha-2a monotherapy for chronic hepatitis C with genotype 2 and low viral load: a pilot, randomized study.

Aim: To assess the efficacy and advantages of 4-wk pegylated interferon alpha-2a (peg-IFN-alpha 2a) monotherapy for chronic hepatitis C patients with strong predictors of sustained virologic response (SVR).

Methods: Patients (n = 33) with genotype 2 and low viral load (< 100 KIU/mL), who became HCV RNA negative after 1 wk of IFN treatment, were randomly allocated to receive a 4- or 12-wk treatment course at a ratio of 2:1, respectively, with a subsequent 24-wk follow-up period. Peg-IFN-alpha 2a was administered subcutaneously at a dose of 180 microg or 90 microg once weekly. SVR was defined as absence of serum HCV RNA at the end of the follow-up period.

Results: All patients completed the treatment schedule, and more than half were symptom-free during the treatment. In the 4-wk treatment group, 20 of 22 (91%) patients achieved SVR. Two patients relapsed, but achieved SVR following re-treatment with peg-IFN-alpha 2a alone. In the 12-wk treatment group, 11 of 11 (100%) patients attained SVR.

Conclusion: Our results show that a 4-wk course of peg-IFN-alpha 2a monotherapy can achieve a high SVR rate in "IFN-sensitive" patients, without negatively affecting outcome.