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Combination therapy with interferon‐α and ribavirin in patients with dual hepatitis B and hepatitis C virus infection
Author(s) -
HUNG CHAOHUNG,
LEE CHUANMO,
LU SHENGNAN,
WANG JINGHOUNG,
TUNG HUNGDA,
CHEN CHIENHUNG,
CHANGCHIEN CHISIN
Publication year - 2005
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.2005.03791.x
Subject(s) - medicine , ribavirin , viremia , hepatitis c virus , gastroenterology , hepatitis b virus , alpha interferon , hepatitis b , interferon , hepatitis c , combination therapy , virology , immunology , virus
Background: Patients with dual hepatitis B virus (HBV) and hepatitis C virus (HCV) infection have responded poorly to interferon (IFN) monotherapy. The purpose of the present paper was to assess the effect of combined IFN‐α and ribavirin therapy in patients infected with both hepatitis B and C. Methods: Thirty‐six patients received 3 or 5 MU IFN‐α‐2b thrice weekly and oral ribavirin (800–1200 mg/day) for 24 weeks. All patients had positive hepatitis B surface antigen, antibody to HCV, and HCV‐RNA. Before treatment, one patient had positive hepatitis B e antigen. Eighteen patients had positive HBV‐DNA tested by Amplicor (Cobas Amplicor Monitor, Roche Diagnostics, Branchburg, NJ, USA), with a mean HBV‐DNA level of 3.1 ± 0.9 log copies/mL. Another 72 patients with HCV infection alone served as controls. Results: Adverse events led to withdrawal in three patients receiving 5 MU IFN. Based on an intent‐to‐treat analysis, the biochemical response and serum HCV clearance rate at the end of 48 weeks follow up was similar in patients with dual infection and HCV infection alone (56% vs 72%; and 69% vs 71%, respectively). There was no significant difference in sustained HCV clearance rate between the 3‐MU group ( n = 13) and the 5‐MU group ( n = 23; 85% vs 61%). At the end of 48 weeks follow up, two (11%) of 18 pretreatment viremic patients had negative serum HBV‐DNA (<200 copies/mL), while eight of those without pretreatment viremia had reoccurrence of HBV‐DNA. Conclusions: Combination therapy with IFN‐α and ribavirin was effective in achieving sustained HCV clearance in patients with dual HBV and HCV infection, comparable to those with hepatitis C infection alone. Combination therapy using 3 MU IFN‐α seemed as effective as 5 MU, and was well tolerated in the study population. However, large‐scale control trials are necessary to clarify these findings.