Pegylated interferon alpha-2b plus ribavirin for naive patients with HCV-related cirrhosis.
J Clin Gastroenterol
; 42(6): 734-7, 2008 Jul.
Article
em En
| MEDLINE
| ID: mdl-18285717
ABSTRACT
BACKGROUND:
Data on the efficacy of antiviral therapy in patients with HCV-related compensated cirrhosis are generally drawn from analyzing subgroups in larger trials.AIMS:
(1) To analyze the safety and efficacy of combination therapy in naive patients with HCV-related cirrhosis; (2) to evaluate the factors influencing the sustained virologic response (SVR) in cirrhotic patients by comparison with a group of noncirrhotic patients; (3) to analyze the outcome of cirrhotic patients either acquiring SVR and nonresponders to the antiviral therapy during the posttreatment follow-up.METHODS:
We consecutively enrolled 365 patients with biopsy-proven HCV-related chronic hepatitis meeting the inclusion criteria for pegylated interferon a-2b plus Ribavirin 87 patients had compensated liver cirrhosis and 278 had histologic stages between 1 and 4 according to Ishak's classification.RESULTS:
The 2 groups were comparable for genotype, viral load, and alanine transferase at presentation. Cirrhotic patients were significantly older and had significantly higher body mass index, serum ferritin, and gamma-glutamyl transpeptidase. The rate of side effects was similar in the 2 groups, whereas the rate of SVR was significantly lower in cirrhotic (45.9%) than in noncirrhotic patients (65.8%). Logistic regression analysis showed that genotype 1 to 4 and high viral load were independent variables correlating with nonresponse in the sample as a whole. During follow-up, hepatocellular carcinoma developed in 5/38 (13.2%) cirrhotic patients not responding or relapsing after treatment. No cases of hepatocellular carcinoma were seen among cirrhotic or noncirrhotic patients with a SVR.CONCLUSIONS:
Cirrhotic patients with compensated disease have a reasonably good chance of virologic response and should be offered treatment, carefully monitoring any side-effects.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Antivirais
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Carcinoma Hepatocelular
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Hepatite C Crônica
/
Cirrose Hepática
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article