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Combined alpha interferon and ribavirin for the treatment of hepatitis C in patients with hereditary bleeding disorders
Author(s) -
Shields Pl,
Mutimer Dj,
Douglas Muir,
Susan J. Skidmore,
T Britnell,
Allen Roberts,
Wilde Jt
Publication year - 2000
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2000.01872.x
Subject(s) - ribavirin , medicine , gastroenterology , hepatitis c , alpha interferon , hepatitis c virus , clotting factor , interferon , surgery , immunology , virus
Patients with hereditary bleeding disorders who received non‐virally inactivated plasma‐derived clotting factor concentrates before the mid‐1980s invariably became infected with hepatitis C virus (HCV). Therapy with interferon alpha (IFN‐α) alone has been disappointing in this group. We conducted an open‐label study, using a combination of IFN‐α2b (3 million units three times per week) and ribavirin 1–1.2 g/d in 28 patients with hereditary bleeding disorders. Twenty‐one of the 28 patients had liver biopsy‐confirmed chronic hepatitis (median histological activity index 5; range 1–10) and all patients were HCV RNA positive by PCR. Virological response rate to therapy at 3 months was 82% (23 out of 28). Three HIV co‐infected patients showed an early virological response with loss of HCV RNA, but two subsequently relapsed after 3 and 6 months of therapy. Four patients stopped treatment early (one at 4, one at 7 and two at 9 months) because of treatment‐related side effects, although three of these have maintained a virological response. Seventeen patients completed the 48‐week course. Twenty of the 28 (71%) treated have had a durable virological response with a median follow‐up of 16 months (range 1–24). Combination therapy represents a significant advance in the treatment of hepatitis C in patients with hereditary bleeding disorders.