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Pegylated versus standard interferon‐α in antiviral regimens for post‐transplant recurrent hepatitis C: Comparison of tolerability and efficacy
Author(s) -
TONIUTTO PIERLUIGI,
FABRIS CARLO,
FUMO ELISABETTA,
APOLLONIO LUCA,
CALDATO MAYA,
AVELLINI CLAUDIO,
MINISINI ROSALBA,
PIRISI MARIO
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.1440-1746.2005.03795.x
Subject(s) - medicine , ribavirin , gastroenterology , tolerability , pegylated interferon , discontinuation , hepatitis c , leukopenia , liver biopsy , hepatitis c virus , liver transplantation , interferon , transplantation , surgery , biopsy , chemotherapy , immunology , adverse effect , virus
Background: In the treatment of hepatitis C virus (HCV) infection, regimens including pegylated interferon‐α are superior to those including standard interferon; the present retrospective study was performed to verify whether the same is applicable to biopsy‐proven recurrent hepatitis C (genotype 1b) after liver transplantation (OLT). Methods: Twenty‐four patients (16 male) were studied. Twelve had received interferon‐α 2b (IFN), 9 MU weekly and 12 received pegylated interferon‐α 2b (PEG‐IFN), 0.5 µg/kg weekly. All had received oral ribavirin 600–800 mg/day. Treatment duration was intended for 12 months. A repeat liver biopsy, with evaluation of the Ishak grading and staging scores, was obtained at 1 year. Results: Only 12/24 patients (50%) completed a full year of therapy; 17 (71%) experienced side‐effects requiring a 50% dosage reduction or discontinuation of the IFN, PEG‐IFN and/or ribavirin. This was observed in 6/12 patients (50%) treated with IFN in comparison to 11/12 patients (92%) treated with PEG‐IFN ( P < 0.05). The difference was mainly accounted for by anemia and leukopenia that were reported in 4/12 IFN patients (33%) versus 9/12 PEG‐IFN patients (75%; P < 0.05), respectively. End‐of‐treatment viral response (ETVR) and histological response were always associated and occurred in 4/24 patients (17%), two in each treatment arm. Patients with ETVR were younger, had always completed 1 year of therapy, had had recurrent hepatitis later after transplantation and presented a higher baseline grading score. Conclusions: In the OLT setting, the potential benefits of antiviral treatments including PEG‐IFN may be limited by the poor tolerability of the adopted drugs.