Peg-interferon alone or combined with ribavirin in HCV cirrhosis with portal hypertension: A randomized controlled trial

Marco, Vito Di; Almasio, Piero Luigi; Ferraro, Donatella; Calvaruso, Vincenza; Alaimo, Giuseppe; Peralta, Sergio; Stefano, R. Di

doi:10.1016/j.jhep.2007.04.020

Cited by 97 publications

(93 citation statements)

References 41 publications

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“…This absence of an early virological response can be used as a guide to stopping treatment [26] . Pre transplant higher viral load has been reported as another predictor of SVR [22,25] . To make AVT more tolerable, various dosing strategies have been used including tailoring dose to liver function, shortening the duration of therapy or using haematopoietic growth factors [22,24,25] .…”

Section: Predictors Of Antiviral Therapy Response and Tolerancementioning

confidence: 99%

“…This is difficult to achieve and may represent too long a period for a patient on the waiting list. Predictors of viral clearance include non-genotype 1 and an early virological response [22][23][24][25] . The absence of a ≥ 2 log10 reduction in HCV RNA between baseline and wk 4 has a strong negative predictive value [22][23][24]26,27] .…”

Section: Predictors Of Antiviral Therapy Response and Tolerancementioning

confidence: 99%

“…To make AVT more tolerable, various dosing strategies have been used including tailoring dose to liver function, shortening the duration of therapy or using haematopoietic growth factors [22,24,25] . In decompensated cirrhotics, reported rates of neutropaenia, thrombocytopaenia, anaemia, infection or liver decompensation range from 50%-60%, 30%-50%, 30%-60%, 4%-13% and 11%-20% respectively [22][23][24][25] . Child-Turcotte-Pugh (CTP) C patients are unable to tolerate a course of treatment [23,28] .…”

Section: Predictors Of Antiviral Therapy Response and Tolerancementioning

confidence: 99%

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Strategies to reduce hepatitis C virus recurrence after liver transplantation

Ciria

Pleguezuelo²,

Khorsandi³

et al. 2013

WJH

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Hepatitis C virus (HCV) is a major health problem that leads to chronic hepatitis, cirrhosis and hepatocellular carcinoma, being the most frequent indication for liver transplantation in several countries. Unfortunately, HCV re-infects the liver graft almost invariably following reperfusion, with an accelerated history of recurrence, leading to 10%-30% of patients progressing to cirrhosis within 5 years of transplantation. In this sense, some groups have even advocated for not retransplanting this patients, as lower patient and graft outcomes have been reported. However, the management of HCV recurrence is being optimized and several strategies to reduce post-transplant recurrence could improve outcomes, decrease the rate of re-transplantation and optimize the use of available grafts. Three moments may be the focus of potential actions in order to decrease the impact of viral recurrence: the pretransplant moment, the transplant environment and the post-transplant management. In the pre-transplant setting, it is not well established if reducing the pre transplant viral load affects the risk for HCV progression after transplant. Obviously, antiviral treatment can render the patient HCV RNA negative post transplant but the long-term benefit has not yet been fully established to justify the cost and clinical risk. In the transplant moment, factors as donor age, cold ischemia time, graft steatosis and ischemia/reperfusion injury may lead to a higher and more aggressive viral recurrence. After the transplant, discussion about immunosuppression and the moment to start the treatment (prophylactic, pre-emptive or once-confirmed) together with new antiviral drugs are of interest. This review aims to help clinicians have a global overview of posttransplant HCV recurrence and strategies to reduce its impact on our patients.

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Section: Predictors Of Antiviral Therapy Response and Tolerancementioning

confidence: 99%

Section: Predictors Of Antiviral Therapy Response and Tolerancementioning

confidence: 99%

Section: Predictors Of Antiviral Therapy Response and Tolerancementioning

confidence: 99%

See 1 more Smart Citation

Strategies to reduce hepatitis C virus recurrence after liver transplantation

Ciria

Pleguezuelo²,

Khorsandi³

et al. 2013

WJH

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“…Results with pegylated interferon are even better. In the first study 12 proving the benefits of antiviral therapy in cirrhotics with signs of portal hypertension, 51 cirrhotics received 1mg/kg/wk of pegylated-interferon alpha-2b plus oral ribavirin at a fixed dose of 800mg/d for 52 wks. By intention-to-treat analysis, SVR was achieved in 21.6% patients.…”

Section: Medical Optionmentioning

confidence: 99%

Antiviral Therapy in HCV-Infected Decompensated Cirrhotics

Danish¹

2012

Antiviral Drugs - Aspects of Clinical Use and Recent Advances

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“…Chronic hepatitis B (CHB) and chronic hepatitis C (CHC) are the leading causes of chronic liver disease, cirrhosis, and hepatocellular carcinoma worldwide [1]. The current standard therapy for patients with CHC, treatment with interferon (IFN)-based therapy, is associated with varying degrees of early and late adverse events (AEs) such as fatigue, myalgia, flulike symptoms, or dermatologic, hematologic, gastrointestinal, ophthalmologic, and thyroid dysfunction, and alternations in mood [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2010

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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.

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Peg-interferon alone or combined with ribavirin in HCV cirrhosis with portal hypertension: A randomized controlled trial

Cited by 97 publications

References 41 publications

Strategies to reduce hepatitis C virus recurrence after liver transplantation

Strategies to reduce hepatitis C virus recurrence after liver transplantation

Antiviral Therapy in HCV-Infected Decompensated Cirrhotics

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

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