High dose (780 MIU/52 weeks) interferon monotherapy is highly effective treatment for acute hepatitis C

Pimstone, Neville R.; Powell, Jerry S.; Kotfila, Ronald; Pimstone, Daniel J.; Davidson, Leslie K.

doi:10.1016/s0016-5085(00)85982-x

Cited by 10 publications

(12 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…27 Several studies have evaluated the efficacy of IFN therapy for acute HCV infection. [28][29][30][31][32][33][34][35][36][37][38] However, all studies have substantial limitations. The small number of patients (also in the present study) reflects the rarity of the disease.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous viral clearance in patients with acute hepatitis C can be predicted by repeated measurements of serum viral load

Hofer

Watkins-Riedel

Janata³

et al. 2003

Hepatology

185

153

View full text Add to dashboard Cite

Early interferon (IFN) therapy prevents viral persistence in acute hepatitis C, but in view of the resulting costs and morbidity patients who really need therapy have to be identified. Twelve consecutive patients with acute hepatitis C (9 women, 3 men, mean age: 39.5 ؎ 18.8 y, genotype 1: 7, genotype 3a: 3, 2 could not be genotyped) were studied. The sources of infection were medical procedures in 6, sexual transmission in 3, and intravenous drug abuse in 3 patients. N atural history of acute hepatitis C virus (HCV) infection is variable. Progression to chronic hepatitis occurs in 50% to 84% of cases. [1][2][3][4][5][6][7][8][9] This variation can be partly explained by the mode of transmission of HCV, viral factors, and by the ability of the host to mount a strong T-cell response to eliminate the virus. Acute HCV infection generally has a mild course, most cases are asymptomatic, and fulminant hepatic failure is very rare. 10,11 The long-term sequelae of chronic hepatitis are the subject of ongoing discussions. Carefully conducted epidemiologic studies in well-documented cases of acute hepatitis C indicate that disease follows a very mild course and that occurrence of cirrhosis within the first 25 years after infection is rare. 2,3,7 Treatment of chronic hepatitis C, especially in patients infected with genotype 1 or 4, is still unsatisfactory. Despite improvements in response rates, current combination therapy with pegylated interferon (IFN) alfa-2a or -2b and ribavirin for chronic hepatitis C infection yields response rates from 54% to 56%. 12,13 Prevention of chronicity by early antiviral treatment thus may be important. Because of the infrequent nature of acute hepatitis C the impact of early antiviral therapy has not been well studied and is conflicting. 14 Only in 2 of 6 controlled trials using 3 MU IFN-2b 3 times a week for 6 to 24 weeks 15 eradication of HCV RNA was assessed. In general, transition to chronicity was not different from untreated controls. Only one study using 10 MU of IFN-2b until normalization of transaminase levels reported an 82% sustained virologic response. 16 A recent study 17 using 5 MU IFN alfa-2b for 6 months showed a 98% HCV eradication in Abbreviations: HCV, hepatitis C virus; IFN, interferon; ALT, alanine transaminase. From the

show abstract

Section: Discussionmentioning

confidence: 99%

Spontaneous viral clearance in patients with acute hepatitis C can be predicted by repeated measurements of serum viral load

Hofer

Watkins-Riedel

Janata³

et al. 2003

Hepatology

185

153

View full text Add to dashboard Cite

show abstract

“…Subset 1 included a total of 12 cohort studies [6][7][8][9][10][11][12][13][14][15][16][17] that reported data on serum HCV-RNA clearance. The cohort studies of subset 1 were reviewed to assess the overall likelihood of sustained virological response in treated patients [6][7][8]10,12,13,[15][16][17] and the likelihood of spontaneous HCV RNA clearance in untreated controls [9,11,14], by the Confidence Profile Method using the Fast*Pro software [18][19][20].…”

Section: Search Strategy and Inclusion Criteriamentioning

confidence: 99%

When and how to treat acute hepatitis C?

Licata

Bona

Schepis

et al. 2003

Journal of Hepatology

View full text Add to dashboard Cite

Background: Appropriate treatment of acute hepatitis C is still a matter of controversy due to the lack of large controlled trials.Aim: To assess the effectiveness of interferon as treatment for acute hepatitis C by meta-analysis. Methods: MEDLINE search (1985 -2002) was supplemented with manual searches of reference lists. Studies were included if they were controlled trials comparing interferon to no treatment and if they included patients with either post-transfusion or sporadic acute hepatitis C. Twelve trials were analyzed (414 patients). The outcome assessed was the sustained virological response (SVR) rate (undetectable hepatitis C virus RNA in serum at least 6 months after cessation of therapy).Results: Interferon significantly increased the SVR (risk difference 49%; 95% confidence interval 32.9 -65%) in comparison to no treatment. The risk difference of SVR increased from 5 to 90% when trials were ordered by increasing interferon weekly dose. Delaying therapy by 8 -12 weeks after the onset of disease does not compromise the SVR rate.Conclusions: Current evidence is sufficient to recommend interferon treatment of patients with acute hepatitis C. A later initiation of therapy yields the same likelihood of response as early treatment. A daily induction dose during the 1st month is the best option of treatment. q

show abstract

“…12,13 Five studies were controlled but not randomized, [14][15][16][17][18] and 4 studies lacked a control group and included treated patients only. [19][20][21][22] Most studies were small in size and were heterogeneous with respect to: (1) inclusion criteria and patient characteristics; (2) type of interferon used; (3) dose of interferon, schedule of administration, and duration of treatment; (4) criteria used to assess efficacy and safety; and (5) posttreatment follow-up evaluation ( Table 2).…”

Section: Published Studies On Interferon Therapy For Acute Hepatitis Cmentioning

confidence: 99%

“…Randomized controlled trials (treatment vs. untreated) 6-11 6 105 (11-27) 101 (13-21) Randomized controlled trials (dose comparison) [12][13] 2 79 (6-17) -Controlled, but not randomized trials [14][15][16][17][18] 5 86 (11-36) 100 (10-46) Uncontrolled trials [19][20][21][22] 4 99 (7-44) -Total 17 369 (6-44) 201 control group, 4 [6][7][8][9] were conducted in patients with posttransfusion hepatitis using a single regimen of therapy: alfa interferon in a dose of 3 MU 3 times weekly for 12 weeks. These 4 studies included 74 treated and 67 untreated patients (mean age, 51 Ϯ 4 y) and were fairly homogeneous, allowing for appropriate pooling of data for formal meta-analysis (Table 3).…”

Section: Number Of Untreated Cases (Range)mentioning

confidence: 99%

Therapy of acute hepatitis C

et al. 2002

View full text Add to dashboard Cite

Acute hepatitis C has a high propensity to become chronic, which provides the rationale for treating patients with acute disease attempting to prevent chronicity. Almost all published studies on therapy of acute hepatitis C have been small in size, uncontrolled, and highly heterogeneous as to patient features, dose and duration of treatment, follow‐up evaluation, and criteria used to define efficacy and safety. The published studies on treatment of acute hepatitis C have used standard alfa or beta interferon monotherapy: none have evaluated combination therapy of interferon and ribavirin or peginterferon. Several meta‐analyses of published studies have concluded that initiation of interferon monotherapy during the acute phase of hepatitis C virus (HCV) infection significantly reduces (by 30% to 40%) evolution to chronic hepatitis. The tolerability of interferon in acute hepatitis C has been excellent, even in symptomatic and icteric patients; the side effects and adverse events being similar in type and frequency to those seen when treating chronic cases. Thus, currently available data support treatment of patients with acute hepatitis C, but data are insufficient to draw firm conclusions about which patients to treat, when therapy should be started, or what regimen is optimal. Future studies of adequate size and design should focus on efficacy and tolerability of peginterferons and whether therapy should be started immediately after diagnosis or delayed for 2 to 4 months to avoid treatment of patients who spontaneously recover.

show abstract

High dose (780 MIU/52 weeks) interferon monotherapy is highly effective treatment for acute hepatitis C

Cited by 10 publications

References 0 publications

Spontaneous viral clearance in patients with acute hepatitis C can be predicted by repeated measurements of serum viral load

Spontaneous viral clearance in patients with acute hepatitis C can be predicted by repeated measurements of serum viral load

When and how to treat acute hepatitis C?

Therapy of acute hepatitis C

Contact Info

Product

Resources

About