ABSTRACT
Patients with bleeding disorders are frequently infected with hepatitis C virus [HCV]. There are few reports on the effect of standard interferon in these patients and no published report on pegylated interferon. The aim of this study was to compare pegylated interferon alpha-2a and standard interferon alpha with ribavirin in patients with bleeding disorders and chronic HCV infection. Consecutive patients referring to a specialized clinic in Tehran were included in the study. The first 37 patients received pegylated interferon [PEGASYS, Hoffmann-La Roche Inc., Basel, Switzerland], 180 microg weekly and the next 38 patients received standard interferon, 3 million units 3 times a week. Both groups also received ribavirin 800 mg daily. Patients were treated for 48 weeks and were followed for 24 weeks. Liver biopsy was not performed due to the potential risks involved in patients with bleeding disorders. 34 patients in each group completed the study. The intention-to-treat sustained viral response was 34% and 62% in the standard interferon and pegylated interferon group, respectively [p=0.02]. Pegylated interferon alpha-2a and ribavirin is almost twice as effective as standard interferon and ribavirin in treating HCV infection in patients with bleeding disorders and is an acceptable treatment option even when histologic data is not available
Subject(s)
Humans , Male , Female , Interferons/classification , Ribavirin , Hepatitis C, Chronic/therapy , /administration & dosage , Hepacivirus , Hemophilia A , Hemorrhagic DisordersABSTRACT
Patients with bleeding disorders are frequently infected with hepatitis C virus [HCV]. There are few reports on the effect of standard interferon in these patients and no published report on pegylated interferon. The aim of this study was to compare pegylated interferon alpha-2a and standard interferon alpha with ribavirin in patients with bleeding disorders and chronic HCV infection. Consecutive patients referring to a specialized clinic in Tehran were included in the study. The first 37 patients received pegylated interferon [PEGASYS, Hoffmann-La Roche Inc., Basel, Switzerland], 180 microg weekly and the next 38 patients received standard interferon, 3 million units 3 times a week. Both groups also received ribavirin 800 mg daily. Patients were treated for 48 weeks and were followed for 24 weeks. Liver biopsy was not performed due to the potential risks involved in patients with bleeding disorders. 34 patients in each group completed the study. The intention-to-treat sustained viral response was 34% and 62% in the standard interferon and pegylated interferon group, respectively [p=0.02]. Pegylated interferon alpha-2a and ribavirin is almost twice as effective as standard interferon and ribavirin in treating HCV infection in patients with bleeding disorders and is an acceptable treatment option even when histologic data is not available
ABSTRACT
Background: patients with inherited bleeding disorders who regularly receive clotting factors are frequently infected with hepatitis C virus [HCV]. Liver biopsy in these patients is high-risk and not always performed. There is no report on pegylated interferon [PEG-IFN] and ribavirin in patients with bleeding disorders in whom no histologic data is available
Aim: to assess the safety and efficacy of combined PEG-IFN alfa-2a and ribavirin in patients with inherited bleeding disorders and hepatitis C. Methods: We studied 37 patients with inherited bleeding disorders and HCV infection. Patients where planned to receive pegylated interferon alfa 2a [PEG-IFN alfa-2a] 180 micg weekly and ribavirin 800mg daily for 48 weeks. They were then followed for 24 weeks after the end of treatment
Results: early virologic response at week 12 of treatment was achieved in 3 1/34 patients [91%] and end-of-treatment response was achieved in 30/3 1 patients [97%]. Sustained virologic response was 26/32 [81%] and 26/35 [74%] on per-protocol and intention-to-treat analysis respectively. Dose reduction due to adverse effects was necessary in 11 patients
Conclusion: the combination of PEG-IFN alpha 2a and ribavirin is safe and highly effective in patients with inherited bleeding disorders and HCV infection, even when histologic data is absent