Premium
Haematological support during peg‐interferon therapy for HCV‐infected haemophiliacs improves virological outcomes
Author(s) -
KEVANS D.,
FARRELL G.,
HOPKINS S.,
MAHMUD N.,
WHITE B.,
NORRIS S.,
BERGIN C.
Publication year - 2007
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/j.1365-2516.2007.01489.x
Subject(s) - ribavirin , medicine , pegylated interferon , hepatitis c virus , adverse effect , haemophilia , hepatitis c , gastroenterology , virology , immunology , virus , surgery
Summary. Hepatitis C virus‐infected haemophiliacs are traditionally under represented in international treatment studies thus data assessing response to pegylated‐interferon (peg‐IFN) and ribavirin (RBV) in HCV mono‐infected or HCV/HIV co‐infected haemophiliacs are few. Since 2001, 37 haemophiliac patients have received peg‐IFN and RBV according to centre‐based investigator initiated protocols. Primary end points were: early virological response (EVR); end of treatment response (EOTR) and sustained virological response (SVR). An intention‐to‐treat analysis was used. Secondary end points were adverse events, haemopoietic stem cell growth factor use, therapy discontinuations and dose reductions. Hepatitis C virus mono‐infection group (Mono‐I) numbered 20 (60% genotype 1). HCV/HIV co‐infected group (Co‐I) numbered 17 (59% genotype 1/4). Primary end points were: EVR 76%, EOTR 70% and SVR 43%. Comparison of Mono‐I to Co‐I demonstrated: EVR rates of 70% and 82%, respectively; EOTR rates of 65% and 76%, respectively, and SVR rates of 35% and 53%, respectively. SVR rates genotype 1/4 group – 17% (Mono‐I) vs. 30% (Co‐I); SVR rates genotype 2/3 group – 63% (Mono‐I) vs. 86% (Co‐I). Therapy discontinuations: six of 20 (30%) Mono‐I vs. three of 17 (18%) Co‐I. Dose reductions: two of 20 (10%) Mono‐I vs. zero of 17 Co‐I. Haematological support factor use: one of 20 (5%) Mono‐I vs. four of 17 (23.5%) Co‐I. Virological outcomes to peg‐IFN and RBV in HCV‐infected haemophiliacs are comparable to published data relating to other HCV‐infected cohorts. Good virological outcomes can be achieved in HIV co‐infected haemophiliacs particularly when growth factors are used to facilitate full dosing of peg‐IFN and RBV.