Document Detail


Peginterferon alpha-2a and ribavirin treatment of patients with haemophilia and hepatitis C virus infection: a single-centre study of 367 cases.
MedLine Citation:
PMID:  20629950     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/AIMS: Chronic hepatitis C virus infection (HCV) is a major comorbidity in patients with haemophilia. Peginterferon alpha and ribavirin is current standard anti-HCV therapy but there is little information about safety and efficacy of peginterferon alpha-2a and ribavirin combination therapy in these patients.
MATERIAL AND METHODS: In an open-label single-treatment arm cohort study, 367 haemophilia patients seronegative for hepatitis B and human immunodeficiency virus markers and chronically infected with HCV (HCV RNA>50 IU/ml for at least 6 months) received 180 microg of Pegasys and 800-1200 mg of ribavirin according to body weight. Genotypes 1 and 4, mixed and untypable infections were treated for 48 weeks, while genotypes 2 and 3 were treated for 24 weeks. The efficacy of therapy was expressed as sustained virological response (SVR).
RESULTS: Two hundred and twenty-five subjects [61%, 95% confidence interval (CI) 56-66] achieved SVR, 66 patients relapsed and 30 subjects did not respond and nine patients developed breakthrough during treatment. In a multivariate logistic regression model, age<24 odds ratio (OR)=1.8 (95% CI 1.1-3.1), genotype non-1 OR=1.8 (95% CI 1.1-3.2), BMI<25 OR=2.1 (95% CI 1.3-3.3) and HCV RNA<600 000 IU/ml OR=1.7 (95% CI 1.1-3.2) were independent predictors of SVR. Eight patients discontinued the treatment because of persistent neutropaenia and 22 subjects were dropped out because of intractable side effects. Furthermore, two patients died during treatment and five were lost to follow-up after treatment cessation.
CONCLUSIONS: Peginterferon alpha-2a in combination with weight-based ribavirin has SVR rate of 51% for genotype 1 and 71% for genotype non-1 infections in haemophilia patients. Age<24, BMI<25, viral load<600 000 IU/ml and genotype non-1 are the major determinants of SVR achievement in these patients.
Authors:
Seyed-Moayed Alavian; Seyed Vahid Tabatabaei; Maryam Keshvari; Bita Behnava; Seyyed Mohammad Miri; Pegah Karimi Elizee; Kamran Bagheri Lankarani
Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2010-07-08
Journal Detail:
Title:  Liver international : official journal of the International Association for the Study of the Liver     Volume:  30     ISSN:  1478-3231     ISO Abbreviation:  Liver Int.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-16     Completed Date:  2010-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101160857     Medline TA:  Liver Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  1173-80     Citation Subset:  IM    
Affiliation:
Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran, Iran. editor@hepmon.com
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MeSH Terms
Descriptor/Qualifier:
Antiviral Agents / therapeutic use*
Drug Therapy, Combination
Genotype
Hemophilia A / drug therapy*
Hepacivirus / genetics*
Hepatitis C / drug therapy*
Humans
Interferon Alfa-2a / therapeutic use*
Iran
Odds Ratio
Polyethylene Glycols / therapeutic use*
Prospective Studies
RNA, Viral / blood
Ribavirin / therapeutic use*
Chemical
Reg. No./Substance:
0/Antiviral Agents; 0/Polyethylene Glycols; 0/RNA, Viral; 0/peginterferon alfa-2a; 36791-04-5/Ribavirin; 76543-88-9/Interferon Alfa-2a

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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