RESUMO
Adults with inherited disorders of coagulation have one of the highest prevalence rates of hepatitis C among known risk groups. Few data are available on the use of combination therapy with interferon and ribavirin in this population. The patients had HCV RNA detectable in serum by polymerase chain reaction, elevated serum aminotransferase (more than 100 U/l). Liver biopsy was not performed. The treatment with interferon alfa 2 b 3 x 3 million units weekly and ribavirin 800 mg/day for 48 weeks. 19 patients were treated and the sustained virological response was 40% (8 of 19). Hemoglobin mean values decreased during treatment, nevertheless all patients were able to finish treatment with small dose adjustments. The re-treatment of 4 nonrespondent patients (interferon and ribavirin) treated again with Peg-interferon alfa 2 b plus ribavirin proved ineffective too.
Assuntos
Antivirais/uso terapêutico , Hemofilia A/complicações , Hepacivirus/isolamento & purificação , Hepatite C Crônica/tratamento farmacológico , Adolescente , Adulto , Idoso , Criança , Quimioterapia Combinada , Feminino , Hepacivirus/genética , Hepatite C Crônica/complicações , Humanos , Interferon alfa-2 , Interferon-alfa/uso terapêutico , Masculino , Pessoa de Meia-Idade , Polietilenoglicóis/uso terapêutico , Reação em Cadeia da Polimerase , RNA Viral/isolamento & purificação , Proteínas Recombinantes , Estudos Retrospectivos , Ribavirina/uso terapêutico , Resultado do TratamentoAssuntos
Antivirais/uso terapêutico , Hepacivirus/isolamento & purificação , Vírus da Hepatite B/isolamento & purificação , Hepatite B Crônica/tratamento farmacológico , Hepatite C Crônica/tratamento farmacológico , Interferons/uso terapêutico , Adenina/análogos & derivados , Adenina/uso terapêutico , Algoritmos , Protocolos Clínicos , Hepacivirus/genética , Hepacivirus/imunologia , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Humanos , Interferon alfa-2 , Interferon-alfa/uso terapêutico , Lamivudina/uso terapêutico , Organofosfonatos/uso terapêutico , Polietilenoglicóis/uso terapêutico , Proteínas Recombinantes , Ribavirina/uso terapêuticoAssuntos
Antivirais/uso terapêutico , Hepatite Crônica/tratamento farmacológico , Hepatite Viral Humana/tratamento farmacológico , Algoritmos , Hepatite C Crônica/tratamento farmacológico , Hepatite Crônica/diagnóstico , Hepatite Crônica/enzimologia , Hepatite Viral Humana/diagnóstico , Hepatite Viral Humana/enzimologia , Humanos , Interferon alfa-2 , Interferon-alfa/uso terapêutico , Lamivudina/uso terapêutico , Polietilenoglicóis/uso terapêutico , Proteínas Recombinantes , Ribavirina/uso terapêuticoRESUMO
BACKGROUND/AIMS: Previous studies using standard interferon and ribavirin combination therapy suggested that patients infected with HCV-1 and a low pretreatment HCV-RNA level can be treated for 24 weeks without compromising sustained virologic response rates. The aim of the present study was to investigate this schedule in the era of pegylated interferon-alpha plus ribavirin. METHODS: Patients chronically infected with HCV-1 (n=235) and a screening viremia < or =600,000 IU/mL (real-time PCR) were treated with peginterferon alfa-2b 1.5 microg/kg subcutaneously once weekly plus ribavirin 800-1400 mg/day based on body weight for 24 weeks. RESULTS: End-of-treatment and sustained virologic response rates were 80 and 50%, respectively. The 48-week historical control (Manns et al., Lancet 2001;358:958-65) had similar end-of-treatment (74%) but higher sustained virologic response rates (71%). This difference was due to a high virologic relapse rate after 24 weeks of therapy (37%) compared with the historical control (4%). A subset of patients who had undetectable serum HCV-RNA at treatment week 4, however, achieved similar sustained virologic response rate (89%) as in the control group (85%). CONCLUSIONS: HCV-1 infected patients with a low baseline HCV-RNA concentration who become HCV-RNA negative at week 4 may be treated for 24 weeks without compromising sustained virologic response rates.