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Incidence and characterization of serum transaminases elevations in pegylated interferon and ribavirin treated patients with chronic hepatitis C
Author(s) -
THURAIRAJAH P. H.,
THORBURN D.,
HUBSCHER S.,
WHITE A.,
LAI W. K.,
O’DONNELL K.,
MUTIMER D.
Publication year - 2007
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2007.03322.x
Subject(s) - ribavirin , medicine , pegylated interferon , chronic hepatitis , gastroenterology , incidence (geometry) , interferon , virology , immunology , virus , physics , optics
Summary Background A virological response to pegylated‐interferon and ribavirin is typically associated with a prompt fall in serum transaminases. For some patients, transaminases rise during treatment. Aim To assess the frequency and define factors associated with elevations of serum transaminases. Methods A total of 169 treated patients were studied. Transaminase elevations were graded by WHO criteria – grade 0: no value > baseline, grade 1: 1–2x baseline, grade 2: 2.1–5x baseline, grade 3: >5x, grade 4: any rise with evidence of liver failure. Results 60/169 (35%) patients experienced transaminase elevations: 52 grade 1, 6 grade 2, 1 grade 3, 1 grade 4. Overall, end of treatment response and sustained virological response rates were 72% and 55%. Lower rates were observed in the grade 1 elevation group (63% and 40%) compared with patients with grade 0 (79% and 65%) and grade ≥2 elevations (85% and 71%). Grade 1 elevations tended to occur earlier during treatment than grade ≥2 elevations. Transaminase elevations were associated with greater pre‐treatment body weight ( P = 0.006), steatosis ( P = 0.008) and poorer sustained virological response rates ( P = 0.007). Conclusions Transaminase elevations during treatment of chronic Hepatitis C virus with pegylated interferon and ribavirin are common but rarely severe. Mild rises may reflect ongoing viral activity in treatment non‐responders. More significant rises are frequently observed despite a virological response, and may be because of an immuno‐modulating effect of interferon in susceptible patients.