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Hayashi J, Nakashima K, Noguchi A, Hirata M, Akazawa K, Kashiwagi S. Antiviral Effect of Interferon Therapy for Patients with Chronic Hepatitis C. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/095632029200300509] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Thirty-two patients with chronic hepatitis who were positive for hepatitis C virus (HCV) RNA by polymerase chain reaction and had antibody to HCV (anti-HCV), were enrolled in this study. Twenty of them were also positive for antibody to the GOR epitope (anti-GOR). Sixteen of the enrolled patients were treated with human lymphoblastoid interferon for six months. Treatment was initiated with 3 million units of interferon daily for 2 weeks, followed by 3 million units three times a week for 6 weeks and 1.5 million units three times a week for 16 weeks. The efficacy of therapy was assessed by comparison with the results in 16 untreated patients. Aminotransferase values, titre of anti-HCV and anti-GOR antibodies showed significant decreases throughout the therapy compared with baseline levels and the untreated patients. After a 3 month follow-up, nine treated patients (56.3%) had normal aminotransferase activities and six of them eliminated HCV RNA from their sera (37.5%). Three of these six patients became negative for both anti-HCV and anti-GOR antibodies (18.8%). None of the untreated control patients had normal aminotransferase activities or became negative for HCV markers. The present study suggests that human lymphoblastoid interferon can control the disease activity and eliminate hepatitis C virus from patients with chronic hepatitis C.
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Affiliation(s)
- J. Hayashi
- Department of General Medicine, Kyushu University Hospital, Higashi-ku, Fukuoka 812, Japan
| | - K. Nakashima
- Department of General Medicine, Kyushu University Hospital, Higashi-ku, Fukuoka 812, Japan
| | - A. Noguchi
- Department of General Medicine, Kyushu University Hospital, Higashi-ku, Fukuoka 812, Japan
| | - M. Hirata
- Department of General Medicine, Kyushu University Hospital, Higashi-ku, Fukuoka 812, Japan
| | - K. Akazawa
- Department of Medical Information, Kyushu University Hospital, Higashi-ku, Fukuoka 812, Japan
| | - S. Kashiwagi
- Department of General Medicine, Kyushu University Hospital, Higashi-ku, Fukuoka 812, Japan
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2
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Warren RP, Sidwell RW. The Potential Role of Cytokines in the Treatment of Viral Infections. ACTA ACUST UNITED AC 2012. [DOI: 10.1007/bf03258488] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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3
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Zaky S, Kamel SE, Hassan MS, Sallam NA, Shahata MA, Helal SR, Mahmoud H. Preliminary results of ozone therapy as a possible treatment for patients with chronic hepatitis C. J Altern Complement Med 2011; 17:259-63. [PMID: 21417811 DOI: 10.1089/acm.2010.0016] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Medical ozone is more bactericidal, fungicidal, and virucidal than any other natural substance. Some studies proved that ozone infused into donated blood samples can kill viruses 100% of the time. Ozone, because of its special biologic properties, has theoretical and practical attributes to make it a potent hepatitis C virus (HCV) inactivator, which suggests an important role in the therapy for hepatitis C. AIM The study aim is to evaluate the role of ozone therapy in decreasing HCV ribonucleic acid (HCV RNA) load and its effect on the liver enzymes among patients with chronic hepatitis C. METHODS This study included 52 patients with chronic hepatitis C (positive polymerase chain reaction [PCR] for HCV RNA and raised serum alanine transaminase [ALT] for more than 6 months). All patients were subjected to meticulous history taking and clinical examination. Complete blood count, liver function tests, and abdominal ultrasonography were requested for all patients. The ozone group included 40 patients who received major autohemotherapy, minor autohemotherapy, and rectal ozone insufflation. The other 12 patients (conventional group) received silymarin and/or multivitamins. RESULTS There were significant improvements of most of the presenting symptoms of the patients in the ozone group in comparison to the conventional group. ALT and aspartate transaminase (AST) levels normalized in 57.5% and 60% in the ozone group, respectively, in comparison to 16.7% and 8% in the conventional group, respectively. Polymerase chain reaction (PCR) for HCV RNA was negative among 25% and 44.4% after 30 and 60 sessions of ozone therapy, respectively, in comparison to 8% among the conventional group. CONCLUSIONS Ozone therapy significantly improves the clinical symptoms associated with chronic hepatitis C and is associated with normalized ALT and AST levels among a significant number of patients. Ozone therapy is associated with disappearance of HCV RNA from the serum (-ve PCR for HCV RNA) in 25%-45% of patients with chronic hepatitis C.
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Affiliation(s)
- Saad Zaky
- Department of Tropical Medicine and Gastroenterology, Assiut University, Assiut, Egypt.
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4
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Weitzman G, Jacobson I. Peginterferon α-2b in the treatment of hepatitis C. Future Virol 2006. [DOI: 10.2217/17460794.1.3.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Hepatitis C virus (HCV) is a leading public health problem affecting as many as 4 million Americans. Chronic HCV infection can progress to hepatocellular carcinoma, cirrhosis and death. Interferon-α-based therapies, initially as monotherapy and later in combination with ribavirin, have proven effective in the treatment of HCV infection, but standard interferon is hampered pharmacokinetically by a short half life. With the advent of the pegylated-interferons, administered in combination with oral ribavirin, the chances for HCV eradication have improved further. Peginterferon α-2b, the formuation discussed in this review, provides greater antiviral pressure while maintaining a tolerable side-effect profile with more convenient once-weekly dosing. Clinical trials have focused on treatment-naïve patients as well as on many different HCV subpopulations, including difficult-to-treat patients such as previous interferon therapy failures and patients with HCV cirrhosis.
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Affiliation(s)
- Gil Weitzman
- Weill Medical College of Cornell University, 1300 York Avenue, F-231, New York, NY 10021, USA
| | - Ira Jacobson
- Weill Medical College of Cornell University, 450 E. 69th Street, New York, NY 10021, USA
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5
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Gogos CA, Starakis JK, Bassaris HP, Skoutelis AT. Remote abscess formation during interferon-alpha therapy for viral hepatitis. Clin Microbiol Infect 2003; 9:540-2. [PMID: 12848731 DOI: 10.1046/j.1469-0691.2003.00548.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abscess formation at the injection site is an unusual infectious complication of interferon-alpha (IFN-alpha) treatment of chronic hepatitis C virus (HCV) infection, but remote abscess formation during IFN-alpha therapy is very rare. In the present communication, we report three cases of remote abscess formation detected among 68 patients with chronic viral hepatitis treated with IFN-alpha, and review the pertinent English literature. We believe that, as fever and constitutional symptoms are common side effects of IFN-alpha treatment, a high index of suspicion is indicated to exclude abscess formation in cases of unexplained fever during IFN-alpha therapy.
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Affiliation(s)
- C A Gogos
- Patras University Medical School, Department of Medicine, Section of Infectious Diseases, 26500 Rio Patras, Greece.
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Ferenci P, Stauber R, Propst A, Fiedler R, Müller C, Gschwantler M, Schütze K, Datz C, Judmaier G, Vogel W, Krejs GJ, Gangl A. Dose increase augments response rate to interferon-alpha in chronic hepatitis C. Dig Dis Sci 1996; 41:103S-108S. [PMID: 9011466 DOI: 10.1007/bf02087884] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Approximately 50% of patients with chronic hepatitis C respond to treatment with interferon-alpha. The aim of this randomized controlled trial was to evaluate whether an increase in dose of interferon-alpha augments response rate. One hundred thirty-eight patients with newly diagnosed chronic hepatitis C received a three-month course of 3 MU IFN-alpha2b administered every two days. All patients were anti-HCV and HCV-RNA (PCR) positive. Prior to treatment, a liver biopsy was performed. Complete response was defined by normal serum ALT concentrations and disappearance of HCV-RNA. After three months, 60 nonresponders were randomized (stratified according to histology) either to continue 3 MU interferon-alpha2b every two days for another six months (group A, total dose: 410 MU) or to receive increasing doses of interferon-alpha2b (6 MU every two days for three months, followed by 10 MU every two days for three months) (group B, total dose: 870 MU). Serum ALT concentrations were measured monthly and HCV-RNA at three-month intervals. Liver biopsy was repeated six months after end of treatment. Pretreatment characteristics of the randomized patients were: group A: N = 30; male/female: 20/10; age: 54 +/- 10 years; CPH 9, CAH 8, cirrhosis 13; mean ALT 108 +/- 98 units/liter; group B: N = 30; male/female: 21/9; age: 57 +/- 15 years; CPH 10, CAH 9, cirrhosis 11; mean ALT 90 +/- 40 units/liter. At the end of treatment six patients in group B but none in group A became responders [P = 0.011 (Fisher's exact test), intent-to-treat analysis]. All six responders were noncirrhotics. High-dose interferon was not tolerated by six patients in group B. Noncompliance resulted in five dropouts in group A and one in group B. During the six-month follow-up, four of the six responders relapsed. A patient in group A with increased serum ALT concentration but negative HCV-RNA at the end of treatment became a full responder after six months. Of nonresponders to 3 MU interferon alpha2b every two days for three months, 20% responded to higher interferon doses, but none to continued standard dose. Prolonged treatment with interferon may be necessary to obtain a sustained response. However, treatment with higher-dose interferon was not tolerated in 20% of the patients.
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Affiliation(s)
- P Ferenci
- Department of Internal Medicine IV, University of Vienna, Austria
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7
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Picciotto A, Callea F, Varagona G, Bardellini E, Borzone S, De Conca V, Vallarino E, Giudici-Cipriani A, Vitali A, Grasso A. Lymphoblastoid interferon therapy in chronic hepatitis C: biochemical, virological and histological evaluation of two different doses. LIVER 1995; 15:20-4. [PMID: 7776853 DOI: 10.1111/j.1600-0676.1995.tb00101.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Sixty patients of both sexes with biopsy-proven chronic hepatitis C were randomized to receive lymphoblastoid interferon 3 MU or 6 MU three times weekly for 6 months. A follow-up period of 3 months at the end of the therapy was scheduled. Thirty-two patients (53.3%) normalized alanine aminotransferase at the end of the therapy. Of these, 17 received 3 MU (56.7%) and 15 (50%) received 6 MU. Eighteen of the 32 patients (56.2%) relapsed in the follow-up period after treatment. No significant difference in relapse rate was observed between the two groups. The overall percentage of the non-responder patients was 36.6%. The treatment was discontinued because of non-compliance and/or side effects in six patients (10%): three in the 3-MU group and three in the 6-MU group. An improvement in liver histology was observed in about a quarter of chronic active hepatitis patients whose overall diagnosis changed to chronic persistent hepatitis. Knodell's score system showed a significant improvement (p < 0.05) with regard to peripheral necrosis, fibrosis and total score. HCV-RNA was positive at the beginning in all patients and it became undetectable in almost all responder patients. In some cases there was no correlation between viraemia and biochemical signs of liver disease. Our study shows that 6 MU does not increase the response rate compared to 3 MU. Moreover, the lower dose is able to improve the liver histology and to abolish the HCV viraemia in responder patients.
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Affiliation(s)
- A Picciotto
- Dipartimento di Medicina Interna, Università di Genova, Italy
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8
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High-dose interferon therapy in patients with chronic hepatitis C: A biochemical and virologic evaluation. Curr Ther Res Clin Exp 1995. [DOI: 10.1016/0011-393x(95)85017-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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9
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Lam NP, DeGuzman LJ, Pitrak D, Layden TJ. Clinical and histologic predictors of response to interferon-alpha in patients with chronic hepatitis C viral infection. Dig Dis Sci 1994; 39:2660-4. [PMID: 7995193 DOI: 10.1007/bf02087706] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
To evaluate if any pretreatment characteristics of patients with chronic hepatitis C (HCV) can be used to predict response to the current recommended dose (3 million units three times a week) and higher doses of interferon-alpha (IFN), we retrospectively assessed the response of 37 patients with HCV who were treated with IFN. Sixteen patients (43%) responded to the standard dose of IFN with normalization of ALT. Weight and liver histology were found to be significant factors for response. The responders weighed significantly less than nonresponders (161.8 +/- 35.5 lb versus 200.3 +/- 45.4 lb, P = 0.008). Seventy-five percent of patients with chronic lobular or persistent hepatitis were responders, whereas only 28% of patients with more advanced hepatitis responded (P = 0.01). There was no correlation between the degree of bile duct damage or steatosis and response rate. This study suggests that obesity and severe histologic injury are negative predictive factors of response to the current recommended dose of IFN. The adequacy of the current recommended dose of IFN in overweight patients needs to be investigated.
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Affiliation(s)
- N P Lam
- Department of Pharmacy Practice, University of Illinois, Chicago 60612
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10
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Effect of therapy with combined interferon and tauroursodeoxycholic acid in chronic hepatitis C: Biochemical and virologic evaluation. Curr Ther Res Clin Exp 1994. [DOI: 10.1016/s0011-393x(05)80802-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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11
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el-Shazly Y, Abdel-Salam AF, Abdel-Ghaffar A, Mohran Z, Saleh SM. Schistosomiasis as an important determining factor for the response of Egyptian patients with chronic hepatitis C to therapy with recombinant human alpha-2 interferon. Trans R Soc Trop Med Hyg 1994; 88:229-31. [PMID: 8036685 DOI: 10.1016/0035-9203(94)90310-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The aim of the present study was to compare the response to recombinant human alpha-2 interferon therapy in 2 groups of Egyptian patients having chronic hepatitis C with or without associated schistosomiasis. Group 1 included 36 patients with associated intestinal schistosomiasis, and group 2 included 24 patients without schistosomiasis. All patients had abnormal serum aminotransferase levels and were negative for hepatitis B surface antigen and anti-hepatitis core antibody, but positive for hepatitis C virus antibody in serum. All patients received interferon at a dose of 3 million units subcutaneously 3 times a week for 6 months and were followed up clinically, biochemically and haematologically during this treatment period and for 6 months thereafter. A second liver biopsy was obtained from every patient after the completion of interferon therapy. Both the percentage of complete response with return to normal of alanine aminotransferase levels during therapy and the overall response rate at 6 months (when patients with a partial response were also included as responders) were significantly lower (P < 0.001) in group 1 (14% and 33% respectively) than in group 2 (63% and 71% respectively). The liver histology also improved significantly in group 2 (46%) compared with group 1 (14%) after completion of therapy (P < 0.05). On the other hand the overall relapse rate in responders, by 6 months after cessation of therapy, was significantly higher (P < 0.05) in group 1 (92%) than in group 2 (59%). These results show that the presence of associated schistosomiasis has to be considered as an important factor in determining the response of Egyptian patients with chronic hepatitis C to therapy with interferon.
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Affiliation(s)
- Y el-Shazly
- Department of General Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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12
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Shiell A, Briggs A, Farrell GC. The cost effectiveness of alpha interferon in the treatment of chronic active hepatitis C. Med J Aust 1994. [DOI: 10.5694/j.1326-5377.1994.tb125830.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Alan Shiell
- Centre for Health Economics Research and EvaluationDepartment of Community MedicineWestmead Hospital Westmead NSW 2145
| | - Andrew Briggs
- Centre for Health Economics Research and EvaluationDepartment of Community MedicineWestmead Hospital Westmead NSW 2145
| | - Geoffrey C Farrell
- Department of MedicineUniversity of SydneyDepartment of Gastroenterology and HepatologyWestmead Hospital Westmead NSW 2145
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13
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Takada N, Takase S, Takada A. Effects of genotypes of hepatitis C virus on interferon treatment for chronic type C hepatitis. GASTROENTEROLOGIA JAPONICA 1993; 28:268-75. [PMID: 8387438 DOI: 10.1007/bf02779230] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Interferon is commonly used for treatment of type C hepatitis, but the effects are variable and many factors may be responsible. Hepatitis C virus (HCV) can be classified into 4 types, PT, K1, K2a and K2b. Therefore, the responses to interferon treatment in patients with the different HCV genotypes were analyzed. Twenty-four patients with type C hepatitis were treated with 3 to 10 million units of various types of interferon for more than 8 weeks. HCV-RNA encoding the NS5 region (HCV-NS5) was positive in these 24 patients, 16 of which were classified with the K1 type and 8 with the K2 type of HCV. In all patients except for 2, HCV-NS5 became negative within 3 weeks of treatment without relation to the HCV genotypes. Serum alanine aminotransferase levels were normalized in 7 out of 8 patients in the K2 group and in 4 out of 16 patients in the K1 group at the end of 8 weeks. At the 24th week, ALT levels were normalized in 5 out of 6 patients in the K2 group, and in one out of 9 patients in the K1 group. The percentage of patients exhibiting a good response was significantly higher in the K2 group than in the K1 group at both observation periods. During the post-treatment periods, relapse following complete response was found in 3 patients in the K2 group and in one patient in the K1 group. The final effects of interferon were significantly better in the K2 group than in the K1 group.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- N Takada
- Department of Internal Medicine, Kanazawa Medical University, Ishikawa, Japan
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14
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Picciotto A, Varagona G, Valle F, Coviello DA, Lapertosa G, Celle G. Interferon therapy in chronic hepatitis C. Evaluation of a low dose maintenance schedule in responder patients. J Hepatol 1993; 17:359-63. [PMID: 8391041 DOI: 10.1016/s0168-8278(05)80218-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Evidence has accumulated that interferon therapy can be effective in reducing transaminase levels and improving liver histology in patients with chronic hepatitis C. Unfortunately, the relapse rate after discontinuing treatment remains a problem. In this study the efficacy of a low dose of interferon was investigated for preventing relapses in patients who completely responded to a 6-month course of 3 MU 3 times a week. Eighteen out of 30 patients (60%) had normal ALT at the end of the 6th month of therapy. These patients were randomly allocated to receive either 1 MU interferon 3 times a week for 6 months or no treatment. Three patients (33.3%) without maintenance schedule and 4 (44.4%) treated with 1 MU relapsed. HCV-RNA was positive in 23 tested patients at entry and became undetectable in patients with sustained response. Relapse was associated with RNA reappearance. A post-therapy liver biopsy, performed in 8 patients, showed Knodell's score improvement. In conclusion, our study confirms the efficacy of interferon at the dose of 3 MU 3 times a week for 6 months. A low maintenance dose of interferon seems to be ineffective in preventing relapse in patients with chronic HCV infection who have responded to a prior treatment course.
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Affiliation(s)
- A Picciotto
- Department of Internal Medicine, University of Genoa, Italy
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15
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Abstract
The current recommendations for therapy of chronic hepatitis C are a 6-month course of alpha-interferon in doses of 3 million units 3 times weekly. Patients should have compensated chronic liver disease with elevations in serum aminotransferases, serologic evidence of hepatitis C virus (HCV) infection and chronic hepatitis by liver biopsy. At present, a long-term beneficial response to alpha-interferon occurs in only 10-25% of patients. The modest long-term response rate and the restricted recommendations for use of interferon leave several unresolved issues regarding therapy of this disease. Do patients with atypical, severe or advanced disease warrant therapy? What is the optimal dose and duration of treatment? How can one increase the response rate to interferon? How can one predict which patients are likely to benefit from therapy? Which patients are likely to relapse if therapy is stopped? Ultimately, what is needed to answer these issues are better techniques to assess HCV infection and monitor therapy as well as more effective and better-tolerated agents that can be used alone or in combination with alpha-interferon.
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Affiliation(s)
- J H Hoofnagle
- Liver Diseases Section, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892
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Affiliation(s)
- O Weiland
- Dept. of Infectious Diseases, Karolinska Institute, Roslagstull Hospital, Stockholm, Sweden
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Taliani G, Furlan C, Grimaldi F, Clementi C, Lecce R, Manganaro M, Duca F, De Bac C. One course versus two courses of recombinant alpha interferon in chronic C hepatitis. ARCHIVES OF VIROLOGY. SUPPLEMENTUM 1992; 4:294-8. [PMID: 1450706 DOI: 10.1007/978-3-7091-5633-9_66] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Fifty-five patients with antibodies to HCV and chronic liver disease have been enrolled in the study. Thirty-four patients were treated with recombinant alpha interferon (IFN, 3 MU daily for 10 days followed by 3 MU twice/week for 3 months), and were compared to 21 untreated controls. Alanine aminotransferase (ALT) normalization was observed in a significant proportion of treated patients (52.9%), but 66.6% of them experienced a relapse after discontinuation of the therapy. The evaluation of the early ALT behavior after the 10 days priming with daily IFN administration was useful in predicting the response. The administration of a second IFN course with the same schedule and duration as the first course did not increase the efficacy of the treatment. Increased dosage and/or prolonged administration are probably required.
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Affiliation(s)
- G Taliani
- Institute of Tropical and Infectious Diseases, La Sapienza University, Rome, Italy
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18
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Schvarcz R. Chronic posttransfusion non-A, non-B hepatitis and autoimmune chronic active hepatitis-aspects on treatment, prognosis and relation to hepatitis C virus. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES. SUPPLEMENTUM 1991; 79:1-48. [PMID: 1658923 DOI: 10.3109/inf.1991.23.suppl-79.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- R Schvarcz
- Department of Infectious Karolinska Institute, Roslagstull Hospital, Stockholm, Sweden
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Schvarcz R, Glaumann H, Weiland O, Norkrans G, Wejstål R, Frydén A. Interferon alpha-2b treatment of chronic posttransfusion non-A, non-B/C hepatitis: long-term outcome and effect of increased interferon doses in non-responders. SCANDINAVIAN JOURNAL OF INFECTIOUS DISEASES 1991; 23:413-20. [PMID: 1957127 DOI: 10.3109/00365549109075088] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The biochemical and histological long-term outcome of interferon alpha-2b treatment for chronic posttransfusion non-A, non-B/C hepatitis was evaluated in a randomized study. 4/19 treated patients had a sustained response with normal serum alanine aminotransferases (s-ALAT) levels during follow-up, at present for 18-20 months after the end of interferon treatment. None of 11 responders with biochemical relapse normalized their s-ALAT levels during 1 year follow-up after treatment. Histological changes were assessed by a scoring system. The scores for portal inflammation, piecemeal necrosis and fibrosis were essentially unchanged in all treated patients between biopsies taken at the end of treatment and 1 year later. Six non-responders to 3 million units (MU) alpha-2b interferon thrice weekly (t.i.w.) were given 6 MU t.i.w. for at least 8 weeks. None normalized the s-ALAT levels during treatment with the higher dose, instead the side effects were much more pronounced, an obstacle to the usefulness of higher interferon doses. The biochemical non-responders had higher pretreatment histologic inflammation scores indicating a more severe infection. They also had a higher body weight and seemed to have prominent macrovesicular steatosis more often than responders, a finding that could contribute to raised aminotransferases, thereby in some of the non-responders, masking a positive biochemical effect of interferon treatment.
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Affiliation(s)
- R Schvarcz
- Department of Infectious Diseases, Karolinska Institute, Stockholm, Sweden
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Affiliation(s)
- G C Farrell
- Gastroenterology and Liver Unit, Westmead Hospital, New South Wales, Australia
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