Impact of high‐dose interferon induction and ribavirin therapy in patients with chronic hepatitis C relapsing after or not responding to interferon monotherapy

Steindl–Munda, Petra; Ferenci, Péter; Brünner, H.; Nachbaur, K.; Datz, Christian; Gschwantler, Michael; Hofer, Harald; Stauber, Rudolf; Hackl, Franz; Jessner, Wolfgang; Rosenbeiger, M.; Gangl, Alfred; Vogel, Wolfgang

doi:10.1034/j.1600-0676.2003.00838.x

Cited by 12 publications

(7 citation statements)

References 33 publications

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“…Similarly, the results may be applicable to patients with HCV genotype 1 disease for whom combination therapy was halted due to the development of depression, loss of health insurance, or intercurrent life events that mandated premature cessation of treatment, all of which may occur in routine clinical practice. The results may also give hope to patients who relapsed after treatment with conventional interferon‐alpha and ribavirin, therapy that is significantly less effective than peginterferon‐alpha‐2a (40 kDa) and ribavirin [3,9,10].…”

Section: Discussionmentioning

confidence: 99%

Re‐treatment of chronic hepatitis C patients after relapse: efficacy of peginterferon‐alpha‐2a (40 kDa) and ribavirin

Berg

Gonçales

Bernstein

et al. 2006

Journal of Viral Hepatitis

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We conducted a randomized multinational study to determine whether 48 weeks of re-treatment with peginterferon-alpha-2a (40 kDa) plus ribavirin would induce a sustained virological response (SVR) in relapsed chronic hepatitis C patients. Patients who had previously relapsed during 24 weeks of untreated follow-up, after having achieved an end-of-treatment virological response with 24 weeks of peginterferon-alpha-2a (40 kDa)/ribavirin combination therapy, within a phase III trial, were studied. Although the recommended dosage was the same as that used at the end of the initial trial, adjustments were permitted. Data on serious adverse events, or adverse events that resulted in dose reductions or discontinuations, were collected. Following re-treatment, the overall SVR rate in the 64 patients was 55%. The SVR rates in patients infected with hepatitis C virus (HCV) genotype 1 and non-1 genotypes were 51% and 63%, respectively. Early (week 12) virological responses were seen in 39 patients (61%) and were predictive of an SVR. Re-treatment was well tolerated. The most frequent adverse events recorded were fatigue (5%) and abdominal pain (3%). Dosages of peginterferon-alpha-2a (40 kDa) and/or ribavirin were modified because of adverse events in 3% and 13% of patients, and because of laboratory abnormalities in 23% and 5% of patients, respectively. Thus, a 48-week course of peginterferon-alpha-2a (40 kDa) plus ribavirin induces an SVR in 55% of patients who relapsed during follow-up after 24 weeks of combination therapy. Physicians should not hesitate to offer re-treatment to patients who relapse after an initial, 24-week course of combination therapy, or who have prematurely stopped treatment because, for example, of laboratory abnormalities.

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Section: Discussionmentioning

confidence: 99%

Re‐treatment of chronic hepatitis C patients after relapse: efficacy of peginterferon‐alpha‐2a (40 kDa) and ribavirin

Berg

Gonçales

Bernstein

et al. 2006

Journal of Viral Hepatitis

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“…A liver biopsy showed stage 2 fibrosis (according to Metavir Score [21]) with 50% steatosis and a moderate iron deposition (grade II). A year later he participated in a prospective therapy trial [22] and received 1200 mg of ribavirin/day in combination with 5 MU interferon‐alpha 2 b/day (Intron A ® ; AESCA‐Schering Plough, Traiskirchen, Austria) for 14 weeks followed by 5 MU/every other day for the following 24 weeks. He achieved SVR in December 2000.…”

Section: Case Reportsmentioning

confidence: 99%

Hepatocellular carcinoma in long‐term sustained virological responders following antiviral combination therapy for chronic hepatitis C

Scherzer

Reddy

Wrba

et al. 2008

Journal of Viral Hepatitis

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Antiviral treatment results in a sustained virologic response (SVR) in 50-75% of patients with chronic hepatitis C. Long-term follow up studies have observed ongoing SVR in the overwhelming majority of them. Thus chronic hepatitis C is considered 'cured' if an SVR is achieved. Consequently, it is expected that in sustained virologic responders long-term complications of hepatatic C virus (HCV) related chronic liver disease including hepatocellular carcinoma are eliminated or have a decreased incidence. We report on five patients (three from Austria, two from USA) who developed hepatocellular carcinoma during follow up (3-6 years) after achieving SVR. During follow up and at diagnosis all were HCV-RNA neg. None of the patients had other liver diseases. One patient presented with bilateral adrenal metastasis, the remaining four with large hepatic tumours. Three patients were noncirrhotic at the start of treatment at the time of tumour diagnosis. Successful antiviral treatment in HCV patients does not prevent development of hepatocellular carcinoma even in non-cirrhotic livers. Long-term follow up of patients with SVR is mandatory and should include surveillance for hepatocellular carcinoma.

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“…High-dose IFN-␣ induction therapy has been shown to increase the likelihood of an early virological response [20,21]. However, data on the SVR rate are conflicting [20 -23].…”

mentioning

confidence: 99%

Cellular Immune Responses during High‐Dose Interferon‐α Induction Therapy for Hepatitis C Virus Infection

et al. 2009

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Impact of high‐dose interferon induction and ribavirin therapy in patients with chronic hepatitis C relapsing after or not responding to interferon monotherapy

Abstract: High-dose induction therapy does not improve the outcome of interferon/ribavirin therapy in interferon nonresponders or relapsers.

Cited by 12 publications

References 33 publications

Re‐treatment of chronic hepatitis C patients after relapse: efficacy of peginterferon‐alpha‐2a (40 kDa) and ribavirin

Re‐treatment of chronic hepatitis C patients after relapse: efficacy of peginterferon‐alpha‐2a (40 kDa) and ribavirin

Hepatocellular carcinoma in long‐term sustained virological responders following antiviral combination therapy for chronic hepatitis C

Cellular Immune Responses during High‐Dose Interferon‐α Induction Therapy for Hepatitis C Virus Infection

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