Complete Response to Twice-a-Day Interferon-Beta with Standard Interferon-Alpha Therapy in Acute Hepatitis C After a Needle-Stick

Oketani, Makoto; Higashi, Takanori; Yamasaki, Narihiro; Shinmyozu, K; Osame, Mitsuhiro; Arima, Terukatsu

doi:10.1097/00004836-199901000-00013

Cited by 16 publications

(15 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[13][14][15] Recent studies by European researchers 4,5 have shown that 75% or 68% of patients have jaundice at the onset of acute hepatitis C, but Japanese studies have found that few patients have jaundice at the onset. 12,19 The latter finding is consistent with the results of this study, in which only 3 of 34 patients had jaundice. The reason for this difference in the incidence of jaundice at the onset of acute hepatitis C between Europeans and Japanese is unclear.…”

Section: Discussionsupporting

confidence: 91%

“…The time from exposure to onset of hepatitis was 7.3 Ϯ 2.1 weeks (mean Ϯ SD) (range, 5-12 weeks) in 10 the patients who had had a needle-stick injury and who were followed from the time of infection until the time symptoms appeared. Of the 5 patients in the early-intervention group, the time from infection to the start of treatment was 15.6 ϫ 2.7 (range, [13][14][15][16][17][18][19][20] weeks.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Short-term interferon-alfa therapy for acute hepatitis C: A randomized controlled trial

et al. 2004

View full text Add to dashboard Cite

Acute hepatitis C often progresses to chronic infection. We undertook a randomized controlled trial to determine whether short-term therapy with interferon (IFN) during acute hepatitis C is effective in preventing the development of chronic hepatitis. Thirty patients with acute hepatitis C were randomized into 1 of 2 treatment groups. IFN therapy was initiated 8 weeks after the onset of acute hepatitis in the early-intervention group and after 1 year of observation in the late-intervention group. Short-term therapy consisted of natural IFN-alfa (6 million units) administered on consecutive days for a period of 4 weeks. Any signs of recrudescence of disease were immediately followed by interval IFN therapy (3 times weekly for 20 weeks). In the early-intervention group, short-term therapy was associated with a sustained virological response in 13 of 15 patients (87%). Follow-up treatment was associated with a sustained virological response in both of the remaining 2 patients (100%). The sustained virological response rate was significantly higher in the early-intervention group (87%, 13 of 15 patients after short-term therapy alone, and 100%, 15 of 15 patients after short-term with or without follow-up therapy) than in the late-intervention group (40%, 6 of 15 patients after short-term therapy alone, and 53%, 8 of 15 patients after short-term therapy with or without follow-up therapy, P ‫؍‬ .021 and P ‫؍‬ .006, respectively). A cute hepatitis that develops after infection with the hepatitis C virus (HCV) is often followed by chronic hepatitis, which may progress eventually to cirrhosis and hepatocellular carcinoma (HCC). 1,2 In the past, the primary causes of infection with HCV were blood transfusion and various medical procedures. Today, blood products in Japan are aggressively screened for HCV and disposable medical devices are in widespread use; there has been a reduction in the incidence of HCV infection. However, patients with acute hepatitis C resulting from treatment-related accidents (needle-stick injury), intravenous drug abuse, sexual contact with HCVpositive partners and unknown causes still occasionally present. [3][4][5] Interferon (IFN) therapy in patients with chronic hepatitis C has considerable potential for preventing the development of HCC, either by eradicating HCV, or by decreasing the activity of hepatitis. 6 -9 However, the therapeutic effects of IFN vary depending on the HCV genotype and viral load. 10,11 Although much research has already been undertaken on IFN therapy for acute hepatitis C, findings in trials that relate to the effectiveness of this therapy have not been particularly favorable. Possible reasons include differences in types of IFN, differences in study populations, and inclusion of patients with posttransfusion hepatitis. 12-17 However, Jaeckel et al. 3 reported that a 24-week course of IFN therapy was effective, and that the response to IFN treatment was more favorable in acute hepatitis C than in chronic hepatitis C. Although randomized controlled trials have been used t...

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Short-term interferon-alfa therapy for acute hepatitis C: A randomized controlled trial

et al. 2004

View full text Add to dashboard Cite

show abstract

“…Furthermore, the rate of dropouts in controlled clinical studies as well as the need for dose reductions or treatment discontinuation are very low. IFNβ has also been shown to be well tolerated and has an excellent safety profile in special patient populations, such as those with acute hepatitis [48][49][50] , cirrhosis [46] , and renal insufficiency [54] . The goals of treatment strategies for HCV-related chronic hepatitis are to eradicate HCV infection and to reduce disease progression.…”

Section: Resultsmentioning

confidence: 99%

“…Interestingly, in this study, the probability of developing clinically significant liver-related events during the follow-up period was not significantly different in untreated versus treated patients (the cumulative probability of decompensation at 60 months was 24% in treated patients and 35% in untreated ones). Although a recent Cochrane review [47] states that there is no definitive conclusion about the safety of IFNβ in acute hepatitis, IFNβ has been used in patients with acute hepatitis without causing significant side effects [48][49][50] . Takano et al [49] studied the effects of six different IFNβ treatment schedules in 97 patients with acute non-A, non-B hepatitis.…”

Section: Clinical Studies Evaluating Combination Therapy (Ifnβ Plus Rmentioning

confidence: 99%

Safety of interferon β treatment for chronic HCV hepatitis

Festi¹,

Sandri²,

Mazzella³

et al. 2004

WJG

View full text Add to dashboard Cite

Hepatitis C is a major cause of liver-related morbidity and mortality worldwide. In fact, chronic hepatitis C is considered as one of the primary causes of chronic liver disease, cirrhosis and hepatocellular carcinoma, and is the most common reason for liver transplantation. The primary objectives for the treatment of HCV-related chronic hepatitis is to eradicate infection and prevent progression of the disease. The treatment has evolved from the use of α-interferon (IFNα) alone to the combination of IFNα plus ribavirin, with a significant improvement in the overall efficacy, and to the newer PEG-IFNs which have further increased the virological response, used either alone or in combination with ribavirin. Despite these positive results, in terms of efficacy, concerns are related to the safety and adverse events. Many patients must reduce the dose of PEG-IFN or ribavirin, others must stop the treatment and a variable percentage of subjects are not suitable owing to intolerance toward drugs. IFNβ represents a potential therapeutic alternative for the treatment of chronic viral hepatitis and in some countries it plays an important role in therapeutic protocols. Aim of the present paper was to review available data on the safety of IFNβ treatment in HCV-related chronic hepatitis.The rates of treatment discontinuation and/or dose modification due to the appearance of severe side effects during IFNβ are generally low and in several clinical studies no requirements for treatment discontinuation and/or dose modifications have been reported. The most frequent side effects experienced during IFNβ treatment are flu-like syndromes, fever, fatigue and injection-site reactions. No differences in terms of side-effect frequency and severity between responders and non-responders have been reported. A more recent study, performed to compare IFNβ alone or in combination with ribavirin, confirmed the good safety profile of both treatments. Similar trends of adverse event frequency have been observed in subpopulations such as patients with genotype-1b HCV hepatitis unresponsive to IFNα treatment or with HCV-related cirrhosis and patients with acute viral hepatitis. If further studies will confirm the efficacy of combined IFNβ and ribavirin treatment, this regimen could represent a safe and alternative therapeutic option in selected patients.Festi D, Sandri L, Mazzella G, Roda E, Sacco T, Staniscia T, Capodicasa S, Vestito A, Colecchia A. Safety of interferon β treatment for chronic HCV hepatitis.

show abstract

“…All seven were PCR negative for HCV RNA at 6 months following the completion of treatment (252). A number of additional single case reports or small studies also document the success of treating acute hepatitis in health care workers who sustained an occupational exposure and developed evidence of productive HCV infection (98,237,241,294,331,347,358). These studies used different doses of different interferon products; however, none of the subjects in these studies progressed to chronic infection, unlike the case reported by Nakano et al (230).…”

Section: Lessons From Acute Hcv Infectionmentioning

confidence: 97%

Managing Occupational Risks for Hepatitis C Transmission in the Health Care Setting

Henderson

2003

Clin Microbiol Rev

106

View full text Add to dashboard Cite

Hepatitis C virus (HCV) infection is a significant contemporary health problem in the United States and elsewhere. Because it is primarily transmitted via blood, hepatitis C infection presents risks for both nosocomial transmission to patients and occupational spread to health care workers. Recent insights into the pathogenesis, immunopathogenesis, natural history, and treatment of infection caused by this unique flavivirus provide a rationale for the use of new strategies for managing occupational hepatitis C infections when they occur. This article reviews this developing information. Recently published data demonstrate success rates in the treatment of “acute hepatitis C syndrome” that approach 100\%, and although these studies are not directly applicable to all occupational infections, they may provide important clues to optimal management strategies. In addition, the article delineates approaches to the prevention of occupational exposures and also addresses the difficult issue of managing HCV-infected health care providers. The article summarizes currently available data about the nosocomial epidemiology of HCV infection and the magnitude of risk and discusses several alternatives for managing exposure and infection. No evidence supports the use of immediate postexposure prophylaxis with immunoglobulin, immunomodulators, or antiviral agents. Based on the very limited data available, the watchful waiting and preemptive therapy strategies described in detail in this article represent reasonable interim approaches to the complex problem of managing occupational HCV infections, at least until more definitive data are obtained

show abstract

Complete Response to Twice-a-Day Interferon-Beta with Standard Interferon-Alpha Therapy in Acute Hepatitis C After a Needle-Stick

Cited by 16 publications

References 13 publications

Short-term interferon-alfa therapy for acute hepatitis C: A randomized controlled trial

Short-term interferon-alfa therapy for acute hepatitis C: A randomized controlled trial

Safety of interferon β treatment for chronic HCV hepatitis

Managing Occupational Risks for Hepatitis C Transmission in the Health Care Setting

Contact Info

Product

Resources

About