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Treatment of chronic hepatitis C in hemophilic patients
1Department of Infectious Diseases, University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic. phusa@med.muni.cz
Insights
Hepatitis C treatment in hemophiliacs using interferon and ribavirin showed varied success. Combination therapies improved sustained virological response rates compared to interferon alone.
Area of Science:
- Hepatology
- Virology
- Hematology
Background:
- Chronic hepatitis C is prevalent in hemophiliacs.
- Treatment options have evolved since 1996.
Purpose of the Study:
- To evaluate the efficacy of different hepatitis C treatment regimens in hemophiliacs.
- To compare outcomes of alpha-interferon monotherapy versus combination therapies.
Main Methods:
- Retrospective analysis of 22 hemophiliacs treated between 1996 and 2001.
- Treatment regimens included alpha-interferon (IFN) monotherapy, IFN with ribavirin, and pegylated IFN (PEG-IFN) with ribavirin.
- Sustained virological response (SVR) assessed 24 weeks post-treatment.
Main Results:
- No SVR achieved with alpha-IFN monotherapy (0/6 patients).
- Combination therapy with alpha-IFN and ribavirin yielded SVR in 4/8 naive patients, 1/2 relapsers, and 1/3 non-responders.
- Limited data on PEG-IFN and ribavirin showed SVR in 1/3 patients.
Conclusions:
- Combination therapy, particularly with alpha-IFN and ribavirin, offers improved SVR rates in hemophiliacs.
- Treatment efficacy and tolerability in hemophiliacs appear similar to the general population.
Abstract:
Chronic hepatitis C infection is common among hemophiliacs in all the developed countries. Since 1996, only alpha-interferon (alpha-IFN) in monotherapy has been used for the treatment of chronic hepatitis C in hemophiliacs (6 patients). In Czech Republic a combination therapy with alpha-IFN and ribavirin has been used since 1999 (13 patients). Finally, a combination therapy with pegylated alpha-IFN (PEG-alpha-IFN) and ribavirin is being used since 2001 (still 3 patients). In all cases, the treatment lasted 48 weeks. A sustained virological response (SVR, defined as an undetectable serum HCV RNA level 24 weeks after the treatment was completed) was not achieved in any of 6 patients treated with alpha-IFN alone. A combination therapy with alpha-IFN and ribavirin yielded better results: four of eight patients still untreated with alpha-IFN (naive patients), one of two relapsers, and one of three non-responders to previous alpha-IFN monotherapy achieved SVR. So far the combination therapy with PEG-alpha-IFN and ribavirin has been used only in 3 patients. SVR was achieved in one patient who had relapsed after the combination therapy with IFN-alpha and ribavirin, and in 1 of 2 non-responders to this therapy. We conclude that the efficacy and tolerability of the treatment of chronic hepatitis C in hemophiliacs did not differ from that of chronic hepatitis C in other patients.
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