Efficacy and safety of pegylated IFN alfa 2b alone or in combination with ribavirin in thalassemia major with chronic hepatitis C

Sood, Ajit; Sobti, Praveen; Midha, Vandana; Singla, Dinesh; Kaur, Arshdeep; Kaushal, Sandeep; Sood, Neena; Mittal, Rita; Puri, Sandeep

doi:10.1007/s12664-010-0014-3

Cited by 15 publications

(14 citation statements)

References 17 publications

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“…The overall reported SVR rates in children are 35.6% with standard interferon, 42.8% with Peg-IFNa monotherapy, 46.8% with standard IFNa with RBV combination and 69% with Peg-IFNa and RBV combination. 83 Sood et al 84 reported SVR rates of 70% with Peg-IFNa2b and RBV in thalassemic children between 3 and 15 years of age with transfusion acquired chronic HCV infection.…”

Section: Management Of Hepatitis C Virus In Pediatric Age Groupmentioning

confidence: 99%

“…The SVR rates with Peg-IFNa/RBV combination therapy are around 50% for genotype 1 and 80% for genotype 2/3 infections. 1,2 In the case of genotype 2/3, SVR rates of as high as 84-95% have been reported from some Southeast Asian countries. 3 Currently, there are several comprehensive and up-todate guidelines, issued by leading authorities such as AASLD and EASL, for the management of CH-C. [4][5][6][7] However, there are many special issues which merit attention prior to the implementation of any such guidelines for the management of CH-C in India.…”

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confidence: 99%

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Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part II: INASL Recommendations for Management of HCV in India

Puri

Anand

Saraswat

et al. 2014

Journal of Clinical and Experimental Hepatology

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The estimated prevalence of hepatitis C virus (HCV) infection in India is between 0.5 and 1.5% with hotspots showing much higher prevalence in some areas of northeast India, in some tribal populations and in certain parts of Punjab. Genotype 3 is the most prevalent type of infection. Recent years have seen development of a large number of new molecules that are revolutionizing the treatment of hepatitis C. Some of the new directly acting agents (DAAs) like sofosbuvir have been called game-changers because they offer the prospect of interferon-free regimens for the treatment of HCV infection. These new drugs have not yet been approved in India and their cost and availability is uncertain at present. Till these drugs become available at an affordable cost, the treatment that was standard of care for the whole world before these newer drugs were approved should continue to be recommended. For India, cheaper options, which are as effective as the standard-of-care (SOC) in carefully selected patients, are also explored to bring treatment within reach of poorer patients. It may be prudent to withhold treatment at present for selected patients with genotype 1 or 4 infection and low levels of fibrosis (F1 or F2), and for patients who are non-responders to initial therapy, interferon intolerant, those with decompensated liver disease, and patients in special populations such as stable patients after liver and kidney transplantation, HIV co-infected patients and those with cirrhosis of liver.

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Section: Management Of Hepatitis C Virus In Pediatric Age Groupmentioning

confidence: 99%

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confidence: 99%

Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part II: INASL Recommendations for Management of HCV in India

Puri

Anand

Saraswat

et al. 2014

Journal of Clinical and Experimental Hepatology

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“…Anaemia is the most common side effect of PEG-IFN/RBV and patients with hemoglobinopathies require a higher number of blood transfusions when they are treated with PEG-IFN/RBV [21]. Indeed, in our short case series, all patients needed more blood transfusions to overcome reduction of hemoglobin.…”

Section: Discussionmentioning

confidence: 96%

Challenging clinical cases in HCV infection

et al. 2014

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We present clinical cases, which underline some difficulties in diagnosis and treatment of hepatitis C virus (HCV) infection. Case report #1 shows a patient who avoided clinical follow-up for HCV until the development of hepatocellular carcinoma. In this patient, non-invasive procedures did not allow to make a differential diagnosis between hydatidosis and hepatocellular carcinoma but diagnosis was only made with liver biopsy.In the case report #2, 24-week treatment with peg-interferon α2 and ribavirin was successfully administered to a HCV genotype-1b infected patient. Shortening HCV treatment did not impair sustained virological response, probably because HCV RNA was low (< 200,000 IU/l) at baseline.Lastly, a case series of patients (#3-6) with hemoglobinopathies is described. Sustained virological response after peg-interferon α2 and ribavirin was achieved in 2 out of 4 patients. While no severe treatment limiting hematological effects were encountered, patients needed more frequent blood transfusions. Thus, new anti-HCV schemes without peg-interferon and ribavirin are urgently needed.

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“…However, adding RBV to IFN significantly improved treatment outcomes so that SVR rates increased up to 54-56% [22][23][24], and this approach has been accepted as the mainstay of CHC management. This combination has been well tolerated even in thalassemia major patients, except for an increase in blood transfusion requirements because of RBV side effects [25].Approximately 70-75% of patients who are infected with HCV in the USA are infected with genotype 1, which is associated with a lower rate of response. Currently, standard treatment with PEG-IFN and RBV results in less than 50% SVR rates in these patients.…”

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confidence: 99%

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confidence: 99%

Basic answers to complicated questions for the course of chronic hepatitis C treatment

Örmeci

Erdem

2012

Expert Review of Gastroenterology & Hepatology

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Hepatitis C virus infection is a long-lasting disease, which causes chronic hepatitis, liver cirrhosis and hepatocellular carcinoma, thus leading to liver-related death. Currently, the optimal treatment for chronic hepatitis C infection is the combination of pegylated interferon and ribavirin. The aim of this review is to assess the long-term clinical outcomes of interferons alone or in combination with ribavirin in the management of chronic hepatitis C.

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Efficacy and safety of pegylated IFN alfa 2b alone or in combination with ribavirin in thalassemia major with chronic hepatitis C

Abstract: In patients with TM and chronic HCV infection, pegylated interferon alfa 2b and ribavirin combination therapy achieves a higher SVR rate than pegylated interferon alone, and is well tolerated except for an increase in blood transfusion requirement.

Cited by 15 publications

References 17 publications

Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part II: INASL Recommendations for Management of HCV in India

Consensus Statement of HCV Task Force of the Indian National Association for Study of the Liver (INASL). Part II: INASL Recommendations for Management of HCV in India

Challenging clinical cases in HCV infection

Basic answers to complicated questions for the course of chronic hepatitis C treatment

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