Efficacy of pegylated interferon alfa-2a or alfa-2b in combination with ribavirin in the treatment of chronic hepatitis caused by hepatitis C virus genotype 1b.

INTRODUCTION: Treatment of chronic hepatitis C (CHC) with pegylated interferon (Peg-IFN) and ribavirin leads to sustained virological response (SVR) in approximately 50% of the patients. SVR depends on hepatitis C virus (HCV) and host factors, including IL28B genotypes. OBJECTIVES: The aim of the study was to investigate the therapeutic efficacy of the difficult-to-treat HCV genotype 1b in patients from the south of Poland. PATIENTS AND METHODS: A total of 260 adult patients with CHC and HCV genotype 1b were treated with Peg-IFN alfa-2a or Peg-IFN alfa-2b with ribavirin for 48 weeks. Efficacy was assessed at 12 weeks (early virological response - EVR), 48 weeks (end-of-treatment response - ETR), and at 6 months (SVR). HCV-RNA, alanine transaminase (ALT), and other biochemical parameters were measured in serum at baseline and at 12, 48, and 72 weeks of therapy. RESULTS: HCV-RNA levels were 3.72 ±1.17 × 106 IU/ml at baseline and decreased significantly at 12 weeks (0.02 ±0.17 × 106 IU/ml); there were no differences between the group treated with Peg-INF alfa-2a and the group treated with Peg-INF alfa-2b. ALT was 94.1 ±7.6 IU/l at baseline and decreased significantly at 12 weeks (42.5 ±3.1 IU/l). The overall EVR, ETR, and SVR were achieved by 63.9%, 77.7%, and 48.1% of the patients, respectively. Tolerance of therapy was similar in both groups. CONCLUSIONS: Efficacy of Peg-IFN alfa-2a with ribavirin is not significantly different from that of Peg-IFN alfa-2b with ribavirin, and SVR was achieved in 48.3% and 44.3% of the patients, respectively. Our study confirms that the efficacy of treatment of patients with HCV genotype 1b from the southern region of Poland is similar to that observed in the overall Polish population.

[Changes of lipid metabolism in patients with chronic viral hepatitis treated with interferon alpha]. / Zaburzenia przemiany lipidów u chorych z przewleklym wirusowym zapaleniem watroby w przebiegu leczenia interferonem alfa.

UNLABELLED: Changes of lipid metabolism are often observed in patients (pts) with chronic viral hepatitis during interferon therapy. Many studies show changes in blood lipids including increase of triglycerides level, decrease of total cholesterol as well as HDL lipoprotein levels. This study was an attempt to widen our knowledge about additional factors responsible for changes in lipid metabolism of pts with chronic viral hepatitis during interferon therapy. The aim of this study was to assess the changes of total cholesterol, triglycerides and LDL-, HDL-lipoproteins levels in blood serum in comparison to: activity of hepatic inflammation, degrees of fibrosis, type of hepatotropic viruses and response to antiviral treatment. MATERIAL AND METHODS: In the group of 53 pts (18 female, 35 male), age 16-61 years old with chronic hepatitis B (13 pts) and chronic hepatitis C (40 pts) treated with interferon alpha we examined the cholesterol, HDL, LDL-lipoproteins and TG levels in blood serum at the beginning of therapy and in the sixth month. Changes of lipids values at the beginning and in the sixth month of therapy were assessed in respect to: necro-inflammatory changes of the liver in histopathological examination, degrees of fibrosis, obesity, loss of the weight during IFN therapy, response to treatment, type of hepatotropic viruses (HBV, HCV), sex and age. RESULTS AND CONCLUSIONS: During sixth month of interferon therapy there was significant decrease of total cholesterol level (before treatment 4.1 +/- 1.0, after treatment 3.8 +/- 0.9, p < 0.05) and HDL-lipoproteins level (before treatment 1.3 +/- 0.35, after treatment 1.1 +/- 0.35, p < 0.05). Increase of TG level was not statistically significant. The necro-inflammatory changes in the liver correlated with the values of TG level. Low activity of hepatic inflammation correlated with the increased TG level at sixth month of therapy. There was not observed effect of any other factors on the lipid metabolism.

[Clinical manifestations and effect of early therapy with interferon-alpha on the course of acute hepatitis C]. / Manifestacja kliniczna i wplyw wczesnego leczenia interferonem alfa na przebieg ostrego wirusowego zapalenia watroby typu C.

UNLABELLED: The aim of the study was to estimate the course of acute hepatitis C and efficacy of 24 weeks monotherapy with interferon alpha 2b (IFN). METHODS: Twenty one patients with acute hepatitis C (age between 26 and 79; 17 females, 4 males) treated in the University Hospital between March 2000 and December 2004 were included into this study. Acute phase of hepatitis C was diagnosed on the basis of HCV-RNA presence by PCR, seroconversion to anti-HCV, clinical symptoms of acute hepatitis and clinical view with epidemiological anamnesis. Biochemical, serological and virusological parameters as well as complete blood count were examined during observation. The efficacy of antiviral treatment with IFN (5 MU daily for 30 days, then 3 MU tiw for 24 week) was studied in 8 patients. Loss of HCV viremia after 24 weeks of treatment and sustained response after the next 24 weeks of follow-up were examined. RESULTS: Jaundice, the main clinical symptom, was observed in 17 (81%) patients, with mean bilirubin level of 147.7 micromol/l. Dyspeptic symptoms were noticed in 71% patients, arthralgia 24%, fatigue in 19% patients. The maximal ALT activity was 1744 U/l, AST 1235 U/l and GGT 372 U/l. The course subsequent to the acute phase was analyzed in 18 patients. Spontaneous loss of viremia was observed in 28% patients. Among the 8 patients included to the therapy early response was observed in 88% and sustained viral response in 75% of them. CONCLUSIONS: Early initiation of interferon alpha therapy in patients with acute hepatitis C significantly reduced the rate of chronicity and was well tolerated by patients.