Efficacy of a 24-week course of PEG-interferon α-2b monotherapy in patients with acute hepatitis C after failure of spontaneous clearance

Santantonio, T.; Fasano, M.; Sinisi, Emanuele; Guastadisegni, A.; Casalino, C; Mazzola, Michele; Francavilla, Ruggiero; Pastore, Giuseppe

doi:10.1016/j.jhep.2004.11.021

Cited by 134 publications

(72 citation statements)

References 19 publications

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“…So, it seems advisable to begin treatment no later than week 12. However, in a short series Santantonio et al achieved SVR in 94% with treatment initiated after 12 weeks with PEG-IFN, but affecting this high SVR were two important factors: 10 of these 16 patients had Gt 2-3 and 8 had a bilirrubin level greater than 3 mg/dL (31).…”

Section: Discussionmentioning

confidence: 97%

Acute hepatitis C in Spain: a retrospective study of 131 cases

Pérez-Álvarez¹,

García-Samaniego

Solá

et al. 2012

Rev. esp. enferm. dig.

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Background and aims: the management of acute hepatitis C (AHC) is controversial. We have conducted a retrospective study to determine the epidemiological and biochemical aspects, the genotypes, the spontaneous clearance of HCV (SVC), and the treatment responses in patients with AHC.Methods: we have retrospectively collected data from 131 patients with AHC from 18 Spanish hospitals.Results: the mean age was 43 ± 16 years (17-83), 69% were symptomatic. The causes of infection were nosocomial in 40% and intravenous drug users in 20%. Eighty two percent had genotype 1. The delay from symptoms-onset to HCV-RNA confirmation was 50 ± 68 days (range, 11-350 days) and to treatment (in 59%) 14 ±1 3 weeks (range, 2-58 days). In the treated group, 80% achieved sustained virological response (SVR) versus 57% SVC in untreated patients (p = 0.004). Up to 96% of those treated within the first 12 weeks had SVR versus 86% of those treated later (p = 0.04). Patients with HCV-RNA(-) at week 4 resolved with or without treatment more frequently than those HCV-RNA(+) (98% versus 69%, p = 0.005). The treatment was not beneficial if HCV-RNA was undetectable at week 12. No differences in SVR were found in genotype 1 patients treated for 24 or 48 weeks. Patients with low baseline viral load achieved higher SVC and SVR. The SVC in patients with bilirubin > 5 mg/dL was 78 versus 40% in those with lower values (p = 0.004).Conclusions: the most common transmission route was nosocomial. SVR was higher in patients treated than SVC in non-treated. Early treatment (before week 12) achieved the highest response rate. SVC and SVR were more common in patients with a low baseline viral load. Undetectable HCV-RNA at week 4 was associated with high SVR and SVC rates. Jaundice was related with SVC.

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Section: Discussionmentioning

confidence: 97%

Acute hepatitis C in Spain: a retrospective study of 131 cases

Pérez-Álvarez¹,

García-Samaniego

Solá

et al. 2012

Rev. esp. enferm. dig.

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“…Initially, it could be shown that a 24-week course of monotherapy with unpegylated IFN could cure more than 90% of the acutely infected patients (Jaeckel et al, 2001;Wiegand et al, 2004). More recent studies demonstrated that pegylated IFN (pegIFN) is equally effective (Santantonio et al, 2005;Wiegand et al, 2006). Currently, there are two pegIFN on the market: pegIFN-a2a and pegIFN-a2b.…”

Section: Hepatitis Cmentioning

confidence: 99%

IFN‐α subtypes: distinct biological activities in anti‐viral therapy

Gibbert

Schlaak

Yang

et al. 2013

British J Pharmacology

154

138

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During most viral infections, the immediate host response is characterized by an induction of type I IFN. These cytokines have various biological activities, including anti‐viral, anti‐proliferative and immunomodulatory effects. After induction, they bind to their IFN‐α/β receptor, which leads to downstream signalling resulting in the expression of numerous different IFN‐stimulated genes. These genes encode anti‐viral proteins that directly inhibit viral replication as well as modulate immune function. Thus, the induction of type I IFN is a very powerful tool for the host to fight virus infections. Many viruses evade this response by various strategies like the direct suppression of IFN induction or inhibition of the IFN signalling pathway. Therefore, the therapeutic application of exogenous type I IFN or molecules that induce strong IFN responses should be of great potential for future immunotherapies against viral infections. Type I IFN is currently used as a treatment in chronic hepatitis B and C virus infection, but as yet is not widely utilized for other viral infections. One reason for this restricted clinical use is that type I IFN belongs to a multigene family that includes 13 different IFN‐α subtypes and IFN‐β, whose individual anti‐viral and immunomodulatory properties have so far not been investigated in detail to improve IFN therapy against viral infections in humans. In this review, we summarize the recent achievements in defining the distinct biological functions of type I IFN subtypes in cell culture and in animal models of viral infection as well as their clinical usage in chronic hepatitis virus infections.

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“…It would be advantageous to identify these people prior to therapy. Spontaneous loss of HCV-RNA from serum occurs within 3 months of infection (Gerlach et al, 2003;Santantonio et al, 2005), so delaying treatment of individuals to target only those who remain HCV-RNA positive is feasible (Santantonio et al, 2006). For the strategy of delayed treatment to be possible, it would be helpful to identify factors, host or viral, that predict spontaneous loss of HCV-RNA from serum.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous loss of hepatitis C virus RNA from serum is associated with genotype 1 and younger age at exposure

Rolfe

Curran

Alexander

et al. 2011

Journal of Medical Virology

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A variety of factors have been associated with spontaneous loss of hepatitis C virus (HCV)‐RNA from serum, including infecting HCV type, although results are conflicting. This study aimed to investigate further whether infecting HCV type was linked to spontaneous loss of HCV‐RNA. Serum samples from 321 untreated HCV antibody positive patients presenting at the Hepatology clinic at Addenbrooke's Hospital, Cambridge between 2004 and 2007 were tested. These individuals were classified either as HCV antibody and HCV‐RNA positive (viremic, n = 219) or HCV antibody positive and repeatedly HCV‐RNA negative (non‐viremic, n = 102). Infecting HCV type was identified by genotyping (viremic) or serotyping (non‐viremic). Binomial regression analysis investigated the independent effect of HCV type on spontaneous loss of HCV‐RNA from serum by comparing the two groups. Ninety‐one percent of patients were found to be either genotype 1 or genotype 3. The prevalence of type 1 infection was greater among non‐viremic (64.5%) than viremic individuals (45%). After controlling for the effects of potential confounding factors, multivariable analyses showed that individuals with type 1 infections were more likely to be non‐viremic than genotype 3 infections (RR = 2.07; 95% CI: 1.25, 3.43; P = 0.005). Individuals infected at an older age were also less likely to become HCV‐RNA negative spontaneously (RR = 0.42 comparing those infected at ≥20 years of age against those infected at <20 years of age, 95% CI: 0.25, 0.72; P = 0.002). In conclusion, the results suggest that HCV genotype 1 infections are more likely than genotype 3 infections to become spontaneously non‐viremic, as are infections acquired at younger age. J. Med. Virol. 83:1338–1344, 2011. © 2011 Wiley‐Liss, Inc.

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Efficacy of a 24-week course of PEG-interferon α-2b monotherapy in patients with acute hepatitis C after failure of spontaneous clearance

Cited by 134 publications

References 19 publications

Acute hepatitis C in Spain: a retrospective study of 131 cases

Acute hepatitis C in Spain: a retrospective study of 131 cases

IFN‐α subtypes: distinct biological activities in anti‐viral therapy

Spontaneous loss of hepatitis C virus RNA from serum is associated with genotype 1 and younger age at exposure

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