High Response Rate to Pegylated Interferon Alpha and Ribavirin Combination Therapy in Hemophilic Children with Chronic Hepatitis C; A Case-Control Study

Abstract

Scarce data is available on the efficacy of Pegylated Interferon (Peg-IFN) and Ribavirin (RBV) combination therapy in hemophilic children with chronic hepatitis C. The aim of this study was to evaluate the efficacy of Peg-IFN and RBV combination therapy for hemophilic children infected with hepatitis C virus (HCV) in comparison with adult hemophilic patients with chronic hepatitis C. A case-control study comprised 31 pediatric hemophilic patients ages under 16 years with previously untreated HCV genotype-1 or -3 infection as the case group and 62 treatment naive adult hemophilic patients with chronic HCV infection as the control group. Case and control groups were matched case by case according to HCV genotype, HCV RNA level and rs12979860 polymorphism. All patients in the case and control groups were treated with Peg-IFN and RBV for 24-48 weeks according to HCV genotype. Sustained virological response (SVR) was achieved in 26 (83.9%) pediatric patients and in 39 (62.9%) of adult patients (P = 0.05, OR = 3.07, 95%CI = 1.03-9.09). The rate of SVR was not different according to HCV genotype, HCV RNA level, and rs12979860 polymorphism in both studied groups whereas achieving early virological response was associated with achievement of SVR in both groups. The efficacy of Peg-IFN and RBV combination therapy in hemophilic children with chronic hepatitis C is higher than that of adult hemophilic patients.

Efficacy and Safety of Generic Sofosbuvir/Ledipasvir Fixed-Dose Combination in Iranian Patients with Chronic Hepatitis C Virus Infection

“…Based on these findings, experts and guidelines recommended to intensify the treatment by adding RBV or prolongation of treatment to a 24-week course when patient harbor cirrhosis and/or previous history of treatment and/or NS5A RASs (20). The on-treatment response was the most important predictor of response of SVR in the IFN-based regimens; however, with the introduction of highly efficient IFN-free DAA regimens, the importance of on-treatment response faded (21)(22)(23)). In the current study, the only case with viremia at the week 4 of treatment achieved SVR; however, large-scale studies are needed to clarify the importance of on-treatment response in clinical decision-making in the IFN-free regimens era.…”

Impact ofIFNL4rs12979860 and rs8099917 polymorphisms on response to Peg-Interferon-α and Ribavirin in patients with congenital bleeding disorder and chronic hepatitis C

“…In the latter study, Age <24, HCV genotype‐non‐1, BMI <25 and baseline HCV RNA<600 000 IU/mL were independent predictors of SVR . A recent study on hemophilic children and adults demonstrated 83.9% and 62.9% SVR rates, respectively . Alavi‐moghaddam et al reported an excellent success rate of 95.6% in 45 non‐cirrhotic hemophiliac patients (mean age 30.4±12.6 years), of which 55.6% were infected with HCV genotype‐1 and 42.2% with HCV genotype‐3.…”

Assessment of Hepatitis C Virus RNA in Peripheral Blood Mononuclear Cells as a Predictor of Response to Pegylated-Interferon and Ribavirin: A Cohort Study

“…(8)(9)(10)(11). Moreover, on-treatment response and viral kinetic are stronger predictors of SVR to PegIFN and RBV treatment compared to baseline parameters (12,13). Among on-treatment responses, rapid virologic response (RVR) and early virologic response (EVR) were used as predictors of SVR and for response-guided therapy (4,5).…”