Acute hepatitis C: In search of the optimal approach to cure

Craxı̀, Antonio; Licata, Anna

doi:10.1002/hep.21085

Cited by 9 publications

(5 citation statements)

References 28 publications

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“…Because the majority of IDUs are aware of the problem of chronic hepatitis C, most of them are also aware of the combination therapy with ribavirin needed and the longer duration of treatment, especially in the case of chronic infection with genotype 1. If the price that has to be paid for treatment of patients with AHC should at least be comparable to that paid for by patients who are treated needlessly, we underscore that, among IDUs, we achieved a rate of SVR equal to that achieved in the German Competence Network for Viral Hepatitis Study (the study population of which was only 22% IDUs), with a 12-week sparing regimen and with a rate of adherence to treatment close to 100%, clearly above that reported in the aforementioned study [12,16]. Furthermore, the HEP-NET study was characterized by 1 suicide attributed to IFN therapy, probably because of the multicenter design of the study.…”

Section: Discussionsupporting

confidence: 72%

Twelve-Week Treatment of Acute Hepatitis C Virus with Pegylated Interferon- -2b in Injection Drug Users

Rosa

Bargiacchi

Audagnotto

et al. 2007

Clinical Infectious Diseases

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Injection drug use is the leading risk factor for infection with hepatitis C virus, and interferon (IFN) treatment in this context is associated with a poor rate of adherence. In this article, we review our experience with injection drug users with acute hepatitis C who are treated with pegylated IFN- alpha -2b for 12 weeks. Acute hepatitis C was diagnosed according to standardized criteria, and patients were treated with a median dosage of IFN- alpha -2b of 1.33 microg/kg per week. A sustained virological response was achieved in 17 (74%) of 23 patients. A sustained virological response was achieved in 14 (87%) of 16 patients treated with a dosage of >or=1.33 microg/kg per week and in 3 (43%) of 7 patients treated with a lower dosage. Sustained virological response was significantly associated only with a pegylated IFN- alpha -2b dosage >or=1.33 microg/kg per week (P=.022). A 12-week regimen of pegylated IFN to treat injection drug users with hepatitis C has a compliance that is much higher than that reported with a 24-week regimen. Adverse effects are minimal if patients are carefully selected.

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Section: Discussionsupporting

confidence: 72%

Twelve-Week Treatment of Acute Hepatitis C Virus with Pegylated Interferon- -2b in Injection Drug Users

Rosa

Bargiacchi

Audagnotto

et al. 2007

Clinical Infectious Diseases

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“…Patients were followed‐up every week during the first month, and then every 4 weeks until at least 24 weeks. Patients with HCV‐RNA levels >10 3 IU/mL on the 12th week were considered for therapy with IFN, while those with HCV‐RNA levels <10 3 IU/mL, or negative on the 12th week, were strictly monitored according to a ‘watchful waiting’ approach [22]. Patients with undetectable HCV‐RNA on at least two consecutive determinations 4 weeks apart after 24 weeks since the onset of hepatitis were considered to have experienced self‐limiting hepatitis (clearers), while those with persistent viraemia and elevated ALT levels after 24 weeks were diagnosed as chronic hepatitis cases (non‐clearers) and underwent liver biopsy and treatment with PEG‐IFN plus ribavirin.…”

Section: Methodsmentioning

confidence: 99%

Serum BLyS/BAFF predicts the outcome of acute hepatitis C virus infection

Tarantino¹,

Marco²,

Petta³

et al. 2009

Journal of Viral Hepatitis

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B-lymphocyte stimulator/B activating factor (BLyS/BAFF) is a tumour necrosis factor-family cytokine that plays a key role in generating and maintaining the mature B-cell pool. BLyS/BAFF expression by macrophages is stimulated by interferon-gamma and interleukin-10, and its serum levels are increased in chronic hepatitis C (CHC). The aim of this study was to assess serum levels of BLyS/BAFF in patients with acute hepatitis C (AHC) and correlate them with disease outcome. We studied 28 patients with AHC (14 males, mean age 59.3 +/- 15 years), followed for at least 7 months since onset, comparing them with 86 CHC patients and 25 healthy blood donors (HBD). BLyS/BAFF levels were assessed at baseline (within 4 weeks of onset) and during follow-up. BLyS/BAFF median levels were significantly higher in AHC (1485 pg/mL) than in CHC (1058 pg/mL) and in HBD (980 pg/mL) (P < 0.001). BLyS/BAFF levels were higher in AHC patients evolving to chronicity (1980 pg/mL) than in those with a self-limited course (1200 pg/mL), (P = 0.02). By logistic regression analysis, higher BLyS/BAFF levels were independently associated with persistence of HCV infection (OR 29.7; 95% CI: 1.73-508.20). High serum levels of BLyS/BAFF at onset of AHC can predict its evolution to chronic infection.

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“…Systematic exploration of new protocols to obtain better information on management of acute hepatitis C is limited by the paucity of cases for study [11]. Prior to 1991, when blood donor screening for antibody to HCV (anti‐HCV) began, the full clinical range of early infections could be evaluated by following transfusion recipients prospectively.…”

Section: Introductionmentioning

confidence: 99%

The course of hepatitis C viraemia in transfusion recipients prior to availability of antiviral therapy

Mosley

Operskalski

Tobler

et al. 2007

Journal of Viral Hepatitis

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Knowing the likely distribution of intervals from hepatitis C infection to first RNA-negativity is important in deciding about therapeutic intervention. Prospectively collected sera and data from the Transfusion-transmitted Viruses Study (1974-1980) provide specific dates of infection and pattern of alanine aminotransferase (ALT) elevations. We examined frequency, timing and correlates of spontaneous resolution for 94 acutely infected transfusion recipients followed for a median of 9.5 months. Later, follow-up sera (>10 years) were available for 27 of the 94 cases from a Veterans Administration (VA) Study (1989-1990). Twenty-five (27%) of the 94 cases were classified as probably resolved during the episode itself. First RNA negativity occurred at 6-50 weeks (median, 19.5 weeks) after infection, and 5-43 weeks (median, 11 weeks) after ALT elevation. Thirteen of the 25 cases remained RNA-negative subsequently; 12 others had 1-6 RNA-positive sera intercalated between first and last RNA-negative results. RNA negativity, therefore, began variably and was interrupted in 12 cases of 25 (48%) by transient RNA-positive sera. Five of these 25 patients who were RNA-negative in the last study specimen had late, Veterans Administration Study follow-up; none showed viraemia. Of the remaining 69 transfusion transmitted virus study recipients, whose last serum was RNA-positive, two cleared viraemia after the last study serum but before late follow-up. Eleven (16%) had 23 intercalated RNA-negative sera before last positivity. RNA status, therefore, needs monitoring for many months before judging the spontaneous outcome as transient negativity may occur. Resolution was significantly more common in women and symptomatic cases; it was not associated with viral load in the infectious donation, HCV genotype, or the recipient's age.

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Acute hepatitis C: In search of the optimal approach to cure

Cited by 9 publications

References 28 publications

Twelve-Week Treatment of Acute Hepatitis C Virus with Pegylated Interferon- -2b in Injection Drug Users

Twelve-Week Treatment of Acute Hepatitis C Virus with Pegylated Interferon- -2b in Injection Drug Users

Serum BLyS/BAFF predicts the outcome of acute hepatitis C virus infection

The course of hepatitis C viraemia in transfusion recipients prior to availability of antiviral therapy

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