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Pegylated versus standard interferon-alpha in antiviral regimens for post-transplant recurrent hepatitis C: Comparison of tolerability and efficacy.
- Source :
-
Journal of gastroenterology and hepatology [J Gastroenterol Hepatol] 2005 Apr; Vol. 20 (4), pp. 577-82. - Publication Year :
- 2005
-
Abstract
- Background: In the treatment of hepatitis C virus (HCV) infection, regimens including pegylated interferon-alpha are superior to those including standard interferon; the present retrospective study was performed to verify whether the same is applicable to biopsy-proven recurrent hepatitis C (genotype 1b) after liver transplantation (OLT).<br />Methods: Twenty-four patients (16 male) were studied. Twelve had received interferon-alpha(2b) (IFN), 9 MU weekly and 12 received pegylated interferon-alpha(2b) (PEG-IFN), 0.5 microg/kg weekly. All had received oral ribavirin 600-800 mg/day. Treatment duration was intended for 12 months. A repeat liver biopsy, with evaluation of the Ishak grading and staging scores, was obtained at 1 year.<br />Results: Only 12/24 patients (50%) completed a full year of therapy; 17 (71%) experienced side-effects requiring a 50% dosage reduction or discontinuation of the IFN, PEG-IFN and/or ribavirin. This was observed in 6/12 patients (50%) treated with IFN in comparison to 11/12 patients (92%) treated with PEG-IFN (P < 0.05). The difference was mainly accounted for by anemia and leukopenia that were reported in 4/12 IFN patients (33%) versus 9/12 PEG-IFN patients (75%; P < 0.05), respectively. End-of-treatment viral response (ETVR) and histological response were always associated and occurred in 4/24 patients (17%), two in each treatment arm. Patients with ETVR were younger, had always completed 1 year of therapy, had had recurrent hepatitis later after transplantation and presented a higher baseline grading score.<br />Conclusions: In the OLT setting, the potential benefits of antiviral treatments including PEG-IFN may be limited by the poor tolerability of the adopted drugs.
- Subjects :
- Adult
Biopsy
Chi-Square Distribution
Drug Therapy, Combination
Female
Hepatitis C surgery
Humans
Immunosuppressive Agents therapeutic use
Interferon alpha-2
Logistic Models
Male
Middle Aged
Polyethylene Glycols
Recombinant Proteins
Recurrence
Retrospective Studies
Ribavirin therapeutic use
Statistics, Nonparametric
Treatment Outcome
Antiviral Agents therapeutic use
Hepatitis C drug therapy
Interferon-alpha therapeutic use
Liver Transplantation
Subjects
Details
- Language :
- English
- ISSN :
- 0815-9319
- Volume :
- 20
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of gastroenterology and hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 15836706
- Full Text :
- https://doi.org/10.1111/j.1440-1746.2005.03795.x