Comparison of adverse effects related to pegylated interferon-based therapy for patients with chronic hepatitis B and chronic hepatitis C in Taiwan

Abstract

Purpose Pegylated interferon (Peg-IFN)-based therapy is effective in treating chronic hepatitis B (CHB) and C (CHC) but frequently induces adverse events (AEs). This study was conducted to compare the incidence of Peg-IFNbased therapy-associated AEs in Taiwanese patients with CHB and CHC. Methods Fifty-six patients with CHB and 103 age-, sexand treatment duration-matched patients with CHC were enrolled. Patients with CHB were treated with Peg-IFN-a2a 180 lg/week for 24 weeks (HBeAg ? , n = 31) or 48 weeks (HBeAg -, n = 25); patients with CHC were treated with Peg-IFN-a-2a 180 lg/week plus ribavirin 1,000-1,200 mg/day for 24 weeks (genotype 2/3, n = 57) or 48 weeks (genotype 1, n = 46).Results Significantly higher incidences of Peg-IFN-related AEs, especially neuropsychiatric symptoms, and ribavirin-associated skin manifestations were observed in patients with CHC compared with those with CHB, with either the 24-or 48-week regimen. Frequencies of laboratory abnormalities, except for anemia, were comparable in both groups. Neither group showed overt hepatic decompensation. Frequency of dose reduction was similar between the groups. Substantially higher rates of early termination and severe AEs were observed in patients with CHC. Conclusions Patients with CHB treated with Peg-IFN had fewer AEs than patients with CHC treated with Peg-IFN/ ribavirin. All patients were treated safely.

Huge Gap Between Clinical Efficacy and Community Effectiveness in the Treatment of Chronic Hepatitis C

“… 12 , 13 However, the HCV treatment rate remains low in primary clinic units. High frequency and intensity of AEs with PegIFN/RBV for HCV patients 52 might cause patients to hesitate to receive therapy and gastrointestinal specialists in primary care units to recommend the therapy.…”

Rheumatoid arthritis following PEG-interferon-alfa-2a plus ribavirin treatment for chronic hepatitis C: a case report and review of the literature

“…In addition, antiviral treatment is accompanied by a wide variety of possible side effects. The most frequent IFN side effects, which have been described not only in CHC, but also in acute hepatitis C [ 19 ] and chronic hepatitis B [ 20 ] are flu-like symptoms, hematologic abnormalities, such as leukopenia and thrombocytopenia, and psychiatric changes, such as irritability and depression. Moreover, immunomodulatory effects of IFN may lead to the induction or exacerbation of autoimmune diseases, including psoriasis, thyroiditis, systemic lupus erythematosus and rarely RA [ 7 , 11 - 14 , 21 - 23 ].…”

Sofosbuvir/velpatasvir regimen promises an effective pan-genotypic hepatitis C virus cure

“… 10 Historically, treatment regimens focused upon pegylated-interferon (Peg-IFN) 11 and later a combination with ribavirin, 12 but at present, the treatment available for hepatitis C targets HCV proteins. However, sustained virologic response (SVR) rates have proved problematic and inconsistent across genotypes with the traditional therapy, 12 , 13 especially those involving hard-to-cure genotype 3 and/or cirrhosis. More often than not, patients developed adverse effects, including neuropsychiatric symptoms, flu-like syndromes, gastrointestinal upsets, and insomnia.…”