Pegylated interferon  -2a plus low-dose ribavirin for the retreatment of dialysis chronic hepatitis C patients who relapsed from prior interferon monotherapy

Liu, CH; Liang, Chen; Cj, Liu; Hb, Tsai; Ph, Hung; Sj, Hsu; Chen, Si; Jw, Lin; My, Lai; Jh, Chen; Pj, Chen; Ds, Chen; Kao, Jia‐Horng

doi:10.1136/gut.2008.165076

Cited by 27 publications

(15 citation statements)

References 10 publications

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“…In terms of safety, we demonstrated that pegylated IFN alfa-2a was well tolerated by hemodialysis patients with acute hepatitis C. Although several studies showed that the premature discontinuation rate in patients receiving conventional IFN was comparable to that in our patients (10.5% vs 5.7%), the choice of pegylated IFN therapy may improve patient compliance while the SVR rates are not compromised [25][26][27]. In addition, the safety of our patients is comparable to that of hemodialysis patients receiving pegylated IFN alfa-2a and is superior to that of hemodialysis patients receiving pegylated IFN alfa-2a plus ribavirin to treat chronic hepatitis C [8][9][10]29].…”

Section: Discussionsupporting

confidence: 77%

“…In addition, patients with acute hepatitis C who had spontaneous clearance of HCV after 16 weeks of observation could sustain viral clearance without treatment. Although low-dose ribavirin therapy can be administered to hemodialysis patients with chronic hepatitis C, these patients need to receive high-dose erythropoietin therapy and close monitoring of ribavirin plasma concentrations to prevent life-threatening anemia [8][9][10]. Therefore, early treatment with IFN-based monotherapy for hemodialysis patients with acute hepatitis C could achieve a high SVR rate and prevent chronic infection for those who do not have spontaneous clearance of HCV after 16 weeks.…”

Section: Discussionmentioning

confidence: 96%

“…Early prediction of virologic responses can help physicians choose the optimal therapeutic strategies for hemodialysis patients with acute hepatitis C. Prior studies indicated that RVR and low baseline HCV RNA levels are strong predictors for SVR in hemodialysis patients with acute hepatitis C or chronic hepatitis C receiving IFN-based therapy [10,29,39]. Our study showed the RVR rate in patients with acute hepatitis C who received pegylated IFN was higher than that in patients with chronic hepatitis C who received either pegylated or conventional IFN (97.1% vs 60% and 44%) [29].…”

Section: Discussionmentioning

confidence: 99%

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Pegylated Interferon Alfa‐2a Monotherapy for Hemodialysis Patients with Acute Hepatitis C

et al. 2010

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Pegylated Interferon Alfa‐2a Monotherapy for Hemodialysis Patients with Acute Hepatitis C

et al. 2010

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“…In 2009, we retreated 35 patients who relapsed from 24 weeks of conventional or pegylated IFN monotherapy with 135 µg/week pegylated IFN and daily 200 mg ribavirin for 48 (HCV genotype 1) or 24 (HCV genotype 2) weeks 165 . The overall SVR rate was 60%, and the SVR rate in the HCV genotype 2 patients was superior to that in the HCV genotype 1 patients (80% vs 52%).…”

Section: Treatment Of Esrd Patients With Chronic Hcv Infectionmentioning

confidence: 99%

Treatment of hepatitis C virus infection in patients with end‐stage renal disease

Liu

Kao

2011

J of Gastro and Hepatol

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Hepatitis C virus (HCV) infection is a major health problem in patients with end-stage renal disease (ESRD). The incidence of acute HCV infection during maintenance dialysis is much higher than that in the general population because of the risk of nosocomial transmission. Following acute HCV infection, most patients develop chronic HCV infection, and a significant proportion develop chronic hepatitis, cirrhosis, and even hepatocellular carcinoma. Overall, chronic hepatitis C patients on hemodialysis bear an increased risk of liver-related morbidity and mortality, either during dialysis or after renal transplantation. Interferon (IFN) therapy is modestly effective for the treatment of HCV infection in ESRD patients. Conventional or pegylated IFN monotherapy has been used to treat acute hepatitis C in ESRD patients with excellent safety and efficacy. Regarding chronic hepatitis C, approximately one-third of patients can achieve a sustained virological response (SVR) after conventional or pegylated IFN monotherapy. The combination of low-dose ribavirin and conventional or pegylated IFN has further improved the SVR rate in treatment-naïve or retreated ESRD patients in clinical trials. Similar to the treatment of patients with normal renal function, baseline and on-treatment HCV virokinetics are useful to guide optimized therapy in ESRD patients. Of particular note, IFN-based therapy is not recommended at the post-renal transplantation stage because of the low SVR rate and risk of acute graft rejection. In conclusion, ESRD patients with HCV infection should be encouraged to receive antiviral therapy, and those who achieve an SVR usually have long-term, durable, virological, biochemical, and histological responses.

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“…134, 135 Liu et al further evaluated PEG-IFN α-2a at a dose of 135 µg per week plus RBV at a dose of 200 mg per day for 48 and 24 weeks in treatment-naïve and -experienced East Asian HCV-1 and HCV-2 patients on hemodialysis. 130,131,136 The SVR rates for treatment-naïve HCV-1 and HCV-2 patients were 64% and 74%, respectively; those for treatment-experienced HCV-1 and HCV-2 patients were 52% and 80%, respectively. Furthermore, Tseng et al evaluated PEG-IFN α-2b at a dose of 1.0 µg per kg of body weight per week plus RBV at a dose of 200 mg three times per week for 48 and 24 weeks in treatment-naïve East Asian HCV-1 and non-HCV-1 patients on hemodialysis, and the overall SVR rate was 62%.…”

mentioning

confidence: 99%

Nanomedicines in the treatment of hepatitis C virus infection in Asian patients: optimizing use of peginterferon alfa

Liu¹,

Kao

2014

IJN

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Asia is endemic for hepatitis C virus (HCV) infection, which is the leading cause of cirrhosis, hepatic decompensation, hepatocellular carcinoma, and liver transplantation worldwide. HCV has six major genotypes and each HCV genotype has its specific geographic distribution. HCV genotypes 1, 2, 3, and 6 are common in Asia. The aim of HCV treatment is to eradicate the virus by effective therapeutic agents; viral clearance is durable after long-term post-treatment follow-up. In most Asian countries, peginterferon alfa (PEG-IFN α) in combination with ribavirin remains the standard of care, and the overall sustained viral response (SVR) rate in Asian HCV patients is higher than that in Western patients. The differences are most significant in patients with HCV genotype 1 (HCV-1) infection, which is attributed to the higher frequency of IFN-responsive or favorable interleukin-28B (IL-28B) genotype in Asian populations than in other ethnic populations. In addition, the introduction of response-guided therapy, where the optimized treatment duration is based on the early viral kinetics during the first 12 weeks of treatment, increases the SVR rate. Recently, telaprevir or boceprevir-based triple therapy was found to further improve the SVR rate in treated and untreated HCV-1 patients and has become the new standard of care in Western and some Asian countries. Many novel direct-acting antiviral agents, either in combination with PEG-IFN α plus ribavirin or used as IFN-free regimens are under active investigation. At the time of this writing, simeprevir and sofosbuvir have been approved in the US. Because the SVR rates in Asian HCV patients receiving PEG-IFN α plus ribavirin therapy are high, health care providers should judiciously determine the clinical usefulness of these novel agents on the basis of treatment duration, anticipated viral responses, patient tolerance, financial burdens, and drug accessibility.

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Pegylated interferon -2a plus low-dose ribavirin for the retreatment of dialysis chronic hepatitis C patients who relapsed from prior interferon monotherapy

Cited by 27 publications

References 10 publications

Pegylated Interferon Alfa‐2a Monotherapy for Hemodialysis Patients with Acute Hepatitis C

Pegylated Interferon Alfa‐2a Monotherapy for Hemodialysis Patients with Acute Hepatitis C

Treatment of hepatitis C virus infection in patients with end‐stage renal disease

Nanomedicines in the treatment of hepatitis C virus infection in Asian patients: optimizing use of peginterferon alfa

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