Interferon therapy for acute hepatitis C viral infection ‐ a review by meta‐analysis

Quin, John

doi:10.1111/j.1445-5994.1997.tb00985.x

Cited by 33 publications

(15 citation statements)

References 25 publications

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“…60 It has been suggested that early treatment of acute hepatitis increases the likelihood of clearing the infection. 66 ' 67 Although treatment is aimed at clearing HCV carriage and preventing the development of cirrhosis, patients with cirrhosis can also improve with therapy by both viral clearance and improvements in liver histology. 68 Currently a wide range of options for treating HCV infection are under investigation.…”

Section: Treatment Of Hcv Infectionmentioning

confidence: 99%

Hepatitis C Virus: An Important Occupational Hazard?

Stevens¹,

Coyle²

2000

Occupational Medicine

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Infection with Heptatis C virus (HCV) is estimated to affect 3% of the world's population and is an important cause of liver disease. It is most commonly transmitted by percutaneous exposure. Although current evidence does not suggest an increased prevalence of HCV infection among healthcare workers, transmission of infection following occupational exposure has been demonstrated. An average transmission rate of 1.8%, following percutaneous injury, has been reported. The risk of transmission is higher from patients with viraemia, as measured by a positive polymerase chain reaction for HCV RNA. After exposure to HCV, healthcare workers should be actively followed up, initially using a test to detect viral RNA. This may faciliate earlier diagnosis and treatment. Recent reports in the UK, of transmission of infection to patients from HCV infected healthcare workers, have prompted a review of the appropriateness of HCV infected individuals undertaking exposure prone procedures.

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Section: Treatment Of Hcv Infectionmentioning

confidence: 99%

Hepatitis C Virus: An Important Occupational Hazard?

Stevens¹,

Coyle²

2000

Occupational Medicine

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“…Approximately 70% of infected persons develop chronic hepatitis, and between 20%–30% of infected persons may develop cirrhosis 2, 3. Several controlled and uncontrolled trials4–10 using different doses and durations of conventional interferon α (IFN‐α) monotherapy in acute HCV reported viral clearance rates ranging between 37% and 100% in IFN‐α–treated patients compared with only 12%–20% of untreated subjects. Most of these studies were problematic because of the small number of subjects, the diverse enrollment criteria, the different types and doses of IFN‐α, the differences in the definition of response, and the duration of follow‐up 11.…”

mentioning

confidence: 99%

Pegylated interferon α therapy in acute hepatitis C: Relation to hepatitis C virus-specific T cell response kinetics

et al. 2004

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Pegylated interferon ␣ (PEG IFN-␣) improves sustained virological response rates in chronic hepatitis C, but neither its role in acute hepatitis C nor the biologic basis for its action has been defined. This prospective study assessed the efficacy of PEG IFN-␣ treatment in acute hepatitis C in relation to the kinetics of hepatitis C virus (HCV)-specific CD4 ؉ T cell responses during therapy and follow-up. Forty subjects with proven acute hepatitis C who received either PEG IFN-␣ plus ribavirin (n ‫؍‬ 20) or PEG IFN-␣ monotherapy (n ‫؍‬ 20) for 24 weeks in addition to 14 untreated subjects with acute hepatitis C were prospectively followed. Serum HCV RNA, HCV-specific CD4 ؉ T cell responses, and cytokine production were measured before and during therapy and at follow-up and correlated to the outcome. The sustained virological response rate was 85% with PEG IFN-␣/ribavirin combination and 80% with PEG IFN-␣ monotherapy. Five untreated subjects had spontaneous recovery. The frequency, magnitude, and breadth of HCV-specific CD4 ؉ T helper 1 responses were significantly higher in treated subjects compared with untreated subjects with self-limited disease or subjects with chronic evolution. The CD4 ؉ T cell responses were maintained in subjects with sustained virological responses and self-limited disease but fluctuated in those who developed chronic infection. In conclusion, PEG IFN-␣ therapy in acute hepatitis induces high rates of sustained virological response and prevents choronicity, probably through efficient early stimulation of multispecific HCV-specific CD4 ؉ T helper 1 responses.

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“…Results for combined interferon and ribavirin in acute treatment of hepatitis C infection are currently inconclusive. The optimal timing of acute therapy after exposure remains uncertain, but some studies report similar results for immediate therapy and therapy that is delayed by 3–6 months 7 , 14 , 23 . ‐ 25 …”

Section: Implications Of Infection In Healthcare Workersmentioning

confidence: 99%

Management of healthcare workers after occupational exposure to hepatitis C virus

Charles

Angus

Sasadeusz

et al. 2003

Medical Journal of Australia

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The increasing rate of hepatitis C virus (HCV) infection in the community means that there is increased risk of occupational exposure for healthcare workers. In metropolitan hospitals in Victoria, we found that 80–150 healthcare workers have occupational exposures from HCV‐infected patients annually. As there is a 1.8%–3% risk of transmission of HCV from a needlestick injury, two to five healthcare workers are likely to acquire HCV each year in Victoria. These needlestick injuries pose a personal, legal and professional risk to healthcare workers and their patients. Recent information shows that early antiviral treatment of acute HCV infection has high cure rates. Current local and international protocols for management of healthcare workers exposed to HCV do not address these issues. We propose a management protocol after needlestick injury that is stratified according to the likelihood of HCV acquisition and potential risk of staff‐to‐patient transmission, and that is consistent with the current legal and clinical context of HCV infection in Australia.

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Interferon therapy for acute hepatitis C viral infection ‐ a review by meta‐analysis

Cited by 33 publications

References 25 publications

Hepatitis C Virus: An Important Occupational Hazard?

Hepatitis C Virus: An Important Occupational Hazard?

Pegylated interferon α therapy in acute hepatitis C: Relation to hepatitis C virus-specific T cell response kinetics

Management of healthcare workers after occupational exposure to hepatitis C virus

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