Clinical efficacy and safety of the combination therapy of peginterferon alpha and ribavirin in cirrhotic patients with HCV infection.
10.3350/kjhep.2010.16.1.38
- Author:
Hong Ryeol CHEONG
1
;
Hyun Young WOO
;
Jeong HEO
;
Ki Tae YOON
;
Dong Uk KIM
;
Gwang Ha KIM
;
Dae Hwan KANG
;
Geun Am SONG
;
Mong CHO
Author Information
1. Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea. jheo@pusan.ac.kr
- Publication Type:Original Article ; English Abstract
- Keywords:
Chronic hepatitis C;
Peginterferon;
Ribavirin;
Liver cirrhosis;
Combination therapy
- MeSH:
Aged;
Antiviral Agents/adverse effects/*therapeutic use;
Drug Therapy, Combination;
Female;
Genotype;
Hepatitis C, Chronic/complications/*drug therapy;
Humans;
Interferon Alfa-2a/adverse effects/*therapeutic use;
Interferon Alfa-2b/adverse effects/*therapeutic use;
Liver Cirrhosis/*complications;
Male;
Middle Aged;
Neutropenia/etiology;
Platelet Count;
Polyethylene Glycols/adverse effects/*therapeutic use;
RNA, Viral/blood;
Retrospective Studies;
Ribavirin/adverse effects/*therapeutic use;
Severity of Illness Index;
Treatment Outcome
- From:The Korean Journal of Hepatology
2010;16(1):38-48
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND/AIMS: The combination therapy of peginterferon (PEG-IFN) and ribavirin is the standard treatment for hepatitis C virus (HCV) infection. However, few trials have involved patients with cirrhosis. The purpose of this study was to elucidate the efficacy and safety of treatment with PEG-IFN and ribavirin in patients with cirrhosis associated with HCV infection. METHOD: A total of 65 patients were treated with PEG-IFN alpha-2a/ribavirin (n=32) or PEG-IFN alpha-2b/ribavirin (n=33). PEG-IFN alpha-2a and PEG-IFN alpha-2b were administered at doses of 180 microg/week and 1.5 microg/kg/week, respectively, and ribavirin was administered orally at doses of 800-200 mg. Patients with HCV genotype 1 and genotype non-1 were treated for 48 and 24 weeks, respectively. The treatment response was assessed based on the sustained virologic response (SVR). RESULTS: The early virologic response (EVR), end-of-treatment response (ETR), and SVR were 70.0%, 52.0%, and 24.0%, respectively, in genotype 1 (n=50). In genotype non-1 (n=15), the ETR was 53.3% and the SVR was 33.3%. The overall SVR did not differ with genotype (1 vs non-1, 24.0% vs. 33.3%; P=0.471) or between decompensated cirrhosis and compensated cirrhosis (20.0% vs. 27.3%, P=0.630). Ten patients developed cirrhotic complications during the treatment, and 11 stopped treatment due to treatment-related adverse events. CONCLUSION: The combination therapy of PEG-IFN and ribavirin exhibited a low efficacy in cirrhotic patients with HCV infection and was associated with frequent serious complications. However, with careful management of complications, the therapy may have a considerable efficacy in some patients with cirrhosis and HCV infection.