Peginterferon-α2a and Ribavirin Combination Therapy in Chronic Hepatitis C

Sj, Hadziyannis; Sette, H; Tr, Morgan; Bălan,; Diago, M.; Marcellin, Patrick; Ramadori, Giuliano; Bodenheimer, Henry C.; Bernstein, David; Rizzetto, Mario; Zeuzem, Stefan; Pockros, P.; Ao, Lin; Am, Ackrill

doi:10.7326/0003-4819-140-5-200403020-00010

Cited by 2,551 publications

(491 citation statements)

References 18 publications

Supporting

Mentioning

453

Contrasting

Unclassified

Order By: Relevance

“…First, such a meta-analysis of observational studies should be interpreted with caution. Randomized controlled trials have studied the thyroid dysfunction of HCV-infected subjects during IFN-α treatment [35,36]. To the best of our knowledge, the data from the observational studies available here for IFN-α naïve patients could provide useful information as well.…”

Section: Discussionmentioning

confidence: 99%

Thyroid Disturbance in Patients with Chronic Hepatitis C Infection: A Systematic Review and Meta-analysis

Shen

Wang

Xie

et al. 2016

JGLD

View full text Add to dashboard Cite

Background & Aims: The involvement of thyroid autoimmunity and dysfunction in patients with chronichepatitis C virus (HCV) infection before interferon-α (IFN-α) therapy remains controversial. We performedthis meta-analysis to evaluate the association of HCV infection with the presence of anti-thyroid antibodiesand dysthyroidism. Methods: A literature search was carried out to collect articles dated up to August 2015 to identify observationalstudies which compared the prevalence of anti-thyroid antibodies and thyroid dysfunction in IFN-α naïvechronic HCV-infected subjects with non-HCV infected controls. Random-effect or fixed-effect meta-analyseswere applied and results reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results: Twelve studies were included, involving 1,735 HCV-infected and 1,868 non-HCV infected subjects.Pooled anti-thyroid antibody prevalence tended to be higher in HCV-infected subjects. The prevalence ofanti-thyroglobulin antibody (TGAb), anti-thyroid peroxidase antibody (TPOAb), anti-thyroid microsomalantibody (ATMA) were 2.40-fold, 1.96-fold and 1.86-fold higher in HCV-infected subjects than in controls,respectively. The prevalence of hypothyroidism also differed by HCV infection status, with a pooled risk of3.10 (95%CI: 2.19-4.40) in HCV-infected subjects. However, the results did not show a significant differencein the prevalence of hyperthyroidism between the two groups.Conclusion: Chronic HCV infection may be an independent risk factor for thyroid disturbance. It is advisablefor the clinicians to monitor both thyroid antibodies and function in the course of chronic HCV infection,independent of IFN-α treatment. Abbreviations: AITD: autoimmune thyroid disease; ATMA: anti-thyroid microsomal antibody; CHC:chronic hepatitis; GD: Graves’ disease; HCV: hepatitis C virus; HT: Hashimoto’s thyroiditis; IFN-α: interferonalpha;NOS: Newcastle-Ottawa quality assessment scale; T3: triiodothyronine; T4: thyroxine; TGAb: antithyroglobulinantibody; TPOAb: anti-thyroid peroxidase antibody.

show abstract

Section: Discussionmentioning

confidence: 99%

Thyroid Disturbance in Patients with Chronic Hepatitis C Infection: A Systematic Review and Meta-analysis

Shen

Wang

Xie

et al. 2016

JGLD

View full text Add to dashboard Cite

show abstract

“…Treatment currently consists of peginterferon alfa and ribavirin with overall sustained virologic response (SVR) of 54%-63%. [1][2][3] Patients infected with genotypes 1 and 4 respond less well than patients with genotypes 2, 3, 5, and 6. In addition to genotype, factors known to influence the response to current antiviral therapy include the duration of infection, age, ethnicity, sex, degree of fibrosis, and body weight.…”

mentioning

confidence: 99%

Steatosis and Chronic Hepatitis C Infection: Mechanisms and Significance

Harrison

2005

Clinical Gastroenterology and Hepatology

View full text Add to dashboard Cite

“…For the treatment of chronic HCV, ribavirin is currently dosed according to body weight, usually between 800 and 1,200 mg daily. 5 In a recent report by Hadziyannis et al, 3 patients with genotype 1 and a high viral load responded better to a ribavirin dose of 1,000 to 1,200 mg daily than to 800 mg/day combined with peginterferon. 3 In contrast to current recommendations, we have recently shown that renal function is of greater importance than body weight for ribavirin clearance, and we therefore have suggested the use of a pharmacokinetic formula based primarily on renal function as a tool to determine the accurate dose of ribavirin for treatment.…”

mentioning

confidence: 99%

“…The standard combination treatment with 12 months of peginterferon combined with ribavirin results in a sustained virological response rate of approximately 40% for this subset of patients. [1][2][3] The mode of action of ribavirin is not firmly established. 4 Furthermore, data regarding the correlation between the dose and the resulting concentration of ribavirin are limited, and the optimal dose is not known.…”

mentioning

confidence: 99%

See 1 more Smart Citation

High-dose ribavirin in combination with standard dose peginterferon for treatment of patients with chronic hepatitis C

et al. 2005

View full text Add to dashboard Cite

Improved treatment regimens for patients with chronic hepatitis C, genotype 1 and high viral load are needed. Increasing the dose of ribavirin has increased the response rate, but experience with doses of more than 1,200 mg/day is limited. The aim of this study was to investigate the safety and tolerance to treatment with a high and individualized dose of ribavirin in combination with peginterferon. Ten patients with chronic hepatitis C, genotype 1 and high viral load were treated with peginterferon alfa-2a and ribavirin for 48 weeks in a prospective trial. The initial ribavirin dose was individualized and calculated from a pharmacokinetic formula based mainly on renal function. Ribavirin plasma concentrations were monitored, and the dose was adjusted to reach the target concentration. Hemoglobin was monitored, and patients were treated with erythropoietin and blood transfusions when indicated. After dose adjustments, the mean dose of ribavirin was 2,540 mg/day (range, 1,600-3,600) at week 24. The main side effect was anemia, which was controlled with erythropoietin. Two patients required blood transfusions. One patient was withdrawn at week 24 because of a lack of viral response, and one patient at week 39 because of side effects, primarily interferon associated. A lthough improvements have been made in the antiviral therapy of chronic hepatitis C virus (HCV), patients with genotype 1 infection with a high level of HCV RNA still pose a therapeutic challenge. The standard combination treatment with 12 months of peginterferon combined with ribavirin results in a sustained virological response rate of approximately 40% for this subset of patients. [1][2][3]

show abstract

Peginterferon-α2a and Ribavirin Combination Therapy in Chronic Hepatitis C

Abstract: Treatment with peginterferon-alpha2a and ribavirin may be individualized by genotype. Patients with HCV genotype 1 require treatment for 48 weeks and a standard dose of ribavirin; those with HCV genotypes 2 or 3 seem to be adequately treated with a low dose of ribavirin for 24 weeks.

Cited by 2,551 publications

References 18 publications

Thyroid Disturbance in Patients with Chronic Hepatitis C Infection: A Systematic Review and Meta-analysis

Thyroid Disturbance in Patients with Chronic Hepatitis C Infection: A Systematic Review and Meta-analysis

Steatosis and Chronic Hepatitis C Infection: Mechanisms and Significance

High-dose ribavirin in combination with standard dose peginterferon for treatment of patients with chronic hepatitis C

Contact Info

Product

Resources

About