Effect of psychological intervention on compliance of patients with hepatitis B treated with pegylated interferon alpha 2a / 中国生化药物杂志

Objective To investigate and analyze the influence of psychological intervention on the compliance of patients with hepatitis B treated with pegylated interferon alpha 2a. Methods 100 patients with hepatitis B treated in our hospital from April 2014 to October 2016 were selected and randomly divided into the control group and the experimental group, with 50 patients in each group. The experimental group and the control group patients were treated with pegylated interferon alpha 2a treatment, treatment time was 48 weeks, no other antiviral therapy. The control group was given routine care, and the experimental group was given psychological intervention on the basis of the control group. The treatment compliance of the two groups was compared and analyzed. Results After the corresponding treatment, the score of mental health in the experimental group was (9.94±2.01) points, and the score of mental health in the control group was (6.41±2.27) points. The scores of mental health in the control group were significantly lower than those in the experimental group, with statistical difference (P<0.05). Among the patients in the experimental group, three patients had poor compliance, 20 patients had good compliance, and 27 patients had good treatment compliance, and the compliance rate was 94%. Among the patients in the control group, 15 patients had poor compliance and the rate of compliance was 70%. The rate of good treatment compliance in the control group (70%) was significantly higher than that in the experimental group (94%), with statistical difference (P<0.05). Conclusion Ppsychological intervention can significantly improve the treatment compliance of pegylated interferon alpha 2a in patients with hepatitis B, and improve the quality of life of patients, so it has the clinical significance of further promotion and application.

PBMCs microRNA-122 level correlates with virological responses to pegylated interferon alpha therapy in patients with hepatitis C genotype 1b / 中华实验和临床病毒学杂志

Objective@#To clarify the predictive power of PBMCs miR-122, as well as other clinical factors, for response to IFNα therapy in chronic HCV infected patients.@*Methods@#A total of 40 patients chronically infected with HCV genotype 1b were enrolled. All the patients received pegylated interferon alpha (PEG-IFN α) in combination with ribavirin for 48 weeks. To perform the analyses, the patients were compared in terms of achieving sustained virological response (SVR) or not (NSVR) at 24th week after antiviral treatment.@*Results@#SVR rate was 72.5% (29/40) and NSVR rate was 27.5% (11/40). SVR group experienced significantly lower HCV viral load, total bilirubin (TBIL), alpha fetal protein (AFP), fibroscan and laminin (LN) compared with NSVR group before treatment (P<0.05). PBMCs miR-122 expression level was also lower in SVR group than that in SNVR group, although the difference was not statistically significant (P>0.05). and there was no significant change of miR-122 level from baseline to the last available measurement between SVR group and NSVR group. However, no significant association was found between baseline PBMCs miR-122 and HCV viral load, body mass index (BMI), alanine transaminase (ALT), aspartate transaminase (AST), degree of liver fibrosis, respectively.@*Conclusions@#Our result suggest that PBMCs miR-122 level is not an efficient biomarker to predict response to IFN alpha therapy in chronic HCV patients. However, baseline HCV viral load, TBIL, AFP and fibroscan may serve as predictive factors.

The Predictive Value of Baseline HBsAg Level and Early Response for HBsAg Loss in Patients with HBeAg-positive Chronic Hepatitis B during Pegylated Interferon Alpha-2a Treatment / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To explore the predictive value of baseline HBsAg level and early response for HBsAg loss in patients with HBeAg-positive chronic hepatitis B during pegylated interferon alpha-2a treatment.</p><p><b>METHODS</b>A total of 121 patients with HBeAg-positive chronic hepatitis B who achieved HBsAg loss were enrolled; all patients were treated with PEG-IFNα-2a 180 μg/week. Serum HBV DNA and serological indicators (HBsAg, anti-HBs, HBeAg, and anti-HBe) were determined before and every 3 months during treatment.</p><p><b>RESULTS</b>The median treatment time for HBsAg loss was 84 weeks (7-273 weeks), and 74.38% (90 cases) of the patients needed extended treatment (> 48 weeks). The correlation between baseline HBsAg levels and the treatment time of HBsAg loss was significant (B = 14.465, t = 2.342, P = 0.021). Baseline HBsAg levels together with the decline range of HBsAg at 24 weeks significantly correlated with the treatment time of HBsAg loss (B = 29.862, t = 4.890, P = 0.000 and B = 27.993, t = 27.993, P = 0.005).</p><p><b>CONCLUSION</b>Baseline HBsAg levels and extended therapy are critical steps toward HBsAg loss. Baseline HBsAg levels together with early response determined the treatment time of HBsAg loss in patients with HBeAg-positive chronic hepatitis B during pegylated interferon alpha-2a treatment.</p>

Changes of tongue and pulse parameters in the patients with chronic hepatitis B after pegylated interferon alpha-2a treatment / 中国基层医药

Objective To observe the changes of tongue and pulse parameters in the patients with chronic hepatitis B(CHB)after pegylated interferon alpha-2a(PEG-IFNα-2a)treatment,to investigate its value in evaluation clinical efficacy of PEG-IFNα-2a treatment.Methods 120 patients with CHB who confirmed to the standard received PEG-IFNα-2a antiviral therapy for 48 weeks,and followed up for 24 weeks.The tongue and pulse parameters were detected by DS01-A type digital tongue and pulse presentation analyzer.The changes of liver function,serum HBV markers,HBV DNA,tongue and pulse parameters were observed before and after treatment.Results 113 patients completed the course of treatment,46 cases received complete response(response rate 40.7%).The response rate of liver stagnation and spleen deficiency group was higher than that of blood stasis group(95%CI:0.010-0.677,P 0.05;W/t,t′=0.688,P >0.05;R,t =1.317,P =0.190;G,t =0.346,P =0.729;B,t =1.720,P =0.088).After 48 weeks treat-ment,and followed up for 24 weeks,the tongue and pulse parameters of response group and non response group were compared with baseline,h3 /h1,h4 /h1 decreased,R value and G value increased,the differences were statistically sig-nificant(Response group:h3 /h1,t =3.004,P =0.003;h4 /h1,t =2.702,P =0.008;R,t′=2.258,P 0.05;h4 /h1,t =0.390,P =0.697 2;h5 /h1,t′=0.957,P >0.05;W/t,t =0.149,P =0.881;R,t =1.343,P =0.181;G,t =0.994,P =0.322;B,t =0.565,P =0.572).Conclusion The changes of tongue and pulse parameters have improved after treatment with PEG-IFNαin patients with CHB. However,the value in predicting the efficacy of antiviral therapy may be limited.

Acute pancreatitis associated with pegylated interferon-alpha-2a therapy in chronic hepatitis C

Chronic hepatitis C virus (HCV) infection is a major cause of liver cirrhosis and hepatocellular carcinoma. Combination therapy of pegylated interferon-alpha (PEG-IFN-α) and ribavirin (RBV) is a current standard treatment for chronic HCV infection in Korea, which has considerable adverse effects. Acute pancreatitis is a rare complication of PEG-IFN-α administration. We report a case of a 62-year-old female who experienced acute pancreatitis after 4 weeks of PEG-IFN-α-2a and RBV combination therapy for chronic HCV infection. The main cause of the acute pancreatitis in this case was probably PEG-IFN-α rather than RBV for several reasons. A few cases have been reported in which acute pancreatitis occurred during treatment with PEG-IFN-α-2b. This is the first report of acute pancreatitis associated with PEG-IFN-α-2a in Korea.

Interferon-induced depression in patients with hepatitis C: an epidemiologic study / Depressão induzida por interferon em pacientes com hepatite C: um estudo epidemiológico

Objective To assess the incidence rate and severity of depressive symptoms in different time points (12, 24 and 48 weeks) in Brazilian patients with HCV treated with PEG IFN plus ribavirin. Methods We conducted an observational prospective study using the Beck Depression Inventory (BDI) and the Center for Epidemiologic Studies Depression Scale (CES-D). Results Fifty patients were included. The assessments with either scale showed the highest score of depressive symptoms in the 24th week of treatment; the mean BDI score before treatment was 6.5 ± 5.3 and the mean CES-D was 10.9 ± 7.8. After 24 weeks, the mean BDI was 16.1 ± 10.2 and mean CES-D was 18.6 ± 13.0; 46% were diagnosed with depression according to combined BDI and CES-D scores. The somatic/psychomotor subscales were highly correlated with overall scale scores . Subjects with history of substance and alcohol abuse had higher risk for IFN-induced depression. Conclusion Treatment with PEG IFN was associated with a high incidence rate of depressive symptoms in this sample of Brazilian patients, as measured by CES-D and BDI. Alcohol and substance abuse increase the risk of PEG IFN-induced depression. .

Objetivo Avaliar a incidência e a gravidade de sintomas depressivos em diferentes intervalos (12, 24 e 48 semanas) em pacientes brasileiros com HCV tratados com PEG IFN mais ribavirina. Métodos Foi feito um estudo prospectivo observacional, usando o Inventário de Depressão de Beck (BDI) e a Escala de Rastreamento Populacional de Depressão (CES-D). Resultados Foram incluídos 50 pacientes. As avaliações com ambas as escalas mostraram os maiores escores de depressão na 24a semana de tratamento; o escore BDI médio antes do tratamento foi de 6,5 ± 5,3 e o CES-D foi 10,9 ± 7,8. Após 24 semanas, o BDI médio foi 16,1± 10,2 e o CES-D foi 18,6 ± 13,0; de acordo com os escores combinados BDI e CES-D, 46% receberam diagnóstico de depressão. As subescalas somática e psicomotora tiveram alta correlação. Indivíduos com história de abuso de substâncias e de álcool apresentaram maior risco de desenvolver depressão por PEG IFN. Conclusão O tratamento com PEG IFN associou-se a uma alta incidência de sintomas depressivos nessa população de pacientes brasileiros, de acordo com a BDI e CES-D. Abuso de álcool e substâncias aumentam o risco de depressão induzida por PEG IFN. .

Clinical Observation of Chronic Hepatitis C Treated by Pegylated Interferon Alpha-2a Plus Ribavirin / 昆明医科大学学报

Objective To observe the efficacy and safety of pegylated interferon apha-2a combined with ribavirin in the treatment of chronic hepatitis C.Methods One hundred and six patients with chronic hepatitis C were divided into 2 groups randomly.Patients in the observation group were treated with pegylated interferon alpha-2a,and patients in the control group were treated with interferon alpha-1b.All patients were given ribavirin according to the weight,and the treatment course was 48 weeks.HCV-RNA was tested before treatment,4 weeks, 12weeks and 24 weeks after the start of treatment,end of treatment,24 weeks after the end of treatment.The adverse reactions were also observed.Results In the observation group,the rapid virological response (RVR) was 77.4%,the complete early virological response (cEVR) was 83.0%,the end treatment virological response (ETVR) was 90.6%, the sustained virological response (SVR) of 24 weeks after the end of treatment was 84.9%.and these rates were significantly higher than the control group.All patients received the whole course of treatment.Condusion Treatment of chronic hepatitis C with pegylated interferon apha-2a combined with ribavirin is effective and safe.

Three Cases of Classic Kaposi Sarcoma Treated with Pegylated Interferon Alpha 2a Intralesional Injection / 대한피부과학회지

Kaposi sarcoma (KS) is a multifocal proliferative vascular tumor often caused by human herpes virus 8. Among the four subtypes of KS, classic KS (CKS) is usually chronic, persisting over many years, but is not life threatening. Because the natural history of KS varies, many kinds of therapeutic option for CKS are available and their assessment may be difficult. We experienced three cases of CKS showing HHV-8 positive in biopsy, no history of immunosuppression and HIV infection, normal chest X-ray, no metastasis, and successfully treated with intralesional injection of Pegylated Interferon-alpha2a (Peg-IFN-alpha2a). After an intralesional Peg-IFN-alpha2a injection of 180 mcg/0.5 ml was administered once a week for 4 months, the size and induration of the lesions reduced greatly and the colors faded away. Histopathological examination of the resolved lesions did not show any evidence of KS with negative HHV-8 results. To the best of our knowledge, this is the first report in the literature for the treatment of CKS with intralesional Peg-IFN-alpha2a injection.

A reduced dose of ribavirin does not influence the virologic response during pegylated interferon alpha-2b and ribavirin combination therapy in patients with genotype 1 chronic hepatitis C

BACKGROUND/AIMS: When combined with pegylated interferon alpha-2b (Peg-IFN alpha-2b) for the treatment of genotype 1 chronic hepatitis C (CHC) in Korea, the current guideline for the initial ribavirin (RBV) dose is based on body weight. However, since the mean body weight is lower for Korean patients than for patients in Western countries, current guidelines might result in Korean patients being overdosed with RBV. METHODS: We retrospectively reviewed the medical records of patients with genotype 1 CHC who were treated with Peg-IFN alpha-2b and RBV combination therapy. We divided the patients into groups A (> or =15 mg/kg/day, n=23) and B (<15 mg/kg/day, n=26), given that the standard dose is 15 mg/kg/day. The clinical course in terms of the virologic response, adverse events, and dose modification rate was compared between the two groups after therapy completion. RESULTS: The early response rates (92.0% vs. 83.3%, P=0.634) and sustained virologic response rates (82.6% vs. 73.1%, P=0.506) did not differ significantly between the two groups. During the treatment period, the RBV dose reduction rate was significantly higher in group A than in group B (60.9% vs. 23.1%, P=0.01). CONCLUSIONS: RBV dose reduction is performed frequently when patients are treated according to the current Korean guidelines. Given that lowering the RBV dose did not appear to decrease the virologic response during therapy, reducing RBV doses below the current Korean guideline may be effective for treatment, especially in low-weight patients.

Efficacy and Tolerability of Peginterferon Alpha Plus Ribavirin in the Routine Daily Treatment of Chronic Hepatitis C Patients in Korea: A Multi-Center, Retrospective Observational Study

BACKGROUND/AIMS: We aimed to evaluate the efficacy and safety of peginterferon plus ribavirin for chronic hepatitis C (CHC) patients under real life setting in Korea. METHODS: We retrospectively analyzed the medical records of 758 CHC patients treated with peginterferon plus ribavirin between 2000 and 2008 from 14 university hospitals in the Gyeonggi-Incheon area in Korea. RESULTS: Hepatitis C virus (HCV) genotype 1 was detected in 61.2% of patients, while genotype 2 was detected in 35.5%. Baseline HCV RNA level was > or =6x10(5) IU/mL in 51.6% of patients. The sustained virological response (SVR) rate was 59.6% regardless of genotype; 53.6% in genotype 1 and 71.4% in genotype 2/3. On multivariate analysis, male gender (p=0.011), early virological response (p80% of the planned dose (p<0.001) were associated with SVR. The rate of premature discontinuation was 35.7%. The main reason for withdrawal was intolerance to the drug due to common adverse events or cytopenia (48.2%). CONCLUSIONS: Our data suggest that the efficacy of peginterferon and ribavirin therapy in Koreans is better in Koreans than in Caucasians for the treatment of CHC, corroborating previous studies that have shown the superior therapeutic efficacy of this regimen in Asians.

Completion of Chronic Hepatitis C Virus Treatment in Interferon-Induced Major Depressive Disorder with Psychotic Features

Interferon (IFN)-associated psychiatric disorders can be managed without interruption to hepatitis C virus (HCV) treatment. The limited number of cases in the literature reporting psychotic depression as an adverse drug reaction to IFN resulted in discontinuation of HCV therapy. The author reports a case of a 49 year-old man with chronic HCV genotype 1a treated with pegylated interferon-alpha and ribavirin developing major depressive disorder with psychotic features. The patient was successfully treated with both an antidepressant and antipsychotic for this suspected IFN-associated adverse drug effect while continuing 12 months of uninterrupted HCV treatment and subsequently achieving sustained hepatitis C virological response. Although IFN can cause distressing psychiatric disturbances, appropriate treatment with psychotropic agents and careful monitoring allows patients to be maintained on a full course of HCV treatment.

A Case of Cutaneous Sarcoidosis Associated with Pegylated Interferon Alpha-2a and Ribavirin Therapy / 대한내과학회지

Pegylated interferon plus ribavirin is the standard treatment regimen in chronic hepatitis C. The main adverse events of pegylated interferon plus ribavirin combination therapy are bone marrow depression, alopecia, insomnia, and influenza-like symptoms. However, there are few reports of cutaneous sarcoidosis occurring during pegylated interferon alpha-2a and ribavirin therapy. Here, we report a case of cutaneous sarcoidosis induced by pegylated interferon alpha-2a and ribavirin during the treatment for chronic hepatitis C. The patient's sarcoidosis improved spontaneously after the treatment.

Polineuropatia desmielinizante inflamatória crônica pós-tratamento com interferon peguilado alfa 2b em um paciente co-infectado HIV/HCV: relato de caso / Chronic inflammatory demyelinating polyneuropathy after treatment with pegylated interferon alpha 2b in a patient with HIV/HCV coinfection: case report

A polineuropatia desmielinizante inflamatória cônica possui forte associação com a infecção pelo HIV e HCV. Uma rara associação entre PDIC e o tratamento da hepatite C com interferon peguilado alfa foi descrita recentemente. Nós descrevemos o primeiro caso de polineuropatia desmielinizante inflamatória crônica em um paciente branco, sexo masculino infectado por HIV e HCV associado a interferon peguilado alfa 2b. O paciente recuperou-se completamente após o uso de imunoglobulina hiperimune endovenosa. Infectologistas e hapatologistas devem estar atentos à esta rara e grave associação, que exige imediata descontinuação da droga e tratamento precoce.

Chronic inflammatory demyelinating polyneuropathy has a strong association with HIV and HCV infection. A rare association between chronic inflammatory demyelinating polyneuropathy and hepatitis C treatment with pegylated interferon alpha was described recently. We described the first case of chronic inflammatory demyelinating polyneuropathy associated with pegylated interferon alpha 2b in a white man infected with HIV and HCV. The patient recovered completely with the use of intravenous hyperimmune immunoglobulin. Infectologists and hepatologists should be alert regarding this rare and serious association, which requires immediately drug discontinuation and early treatment.