The antiviral compound ribavirin modulates the T helper (Th) 1/Th2 subset balance in hepatitis B and C virus-specific immune responses.

Hultgren, Catharina; Milich, David R.; Weiland, Ola; Sällberg, Matti

doi:10.1099/0022-1317-79-10-2381

Cited by 256 publications

(184 citation statements)

References 42 publications

Supporting

Mentioning

167

Contrasting

Unclassified

Order By: Relevance

“…[31][32][33][34][35] This dual effect may help in the control of chronic HBV infection, and thus oral ribavirin might be useful as an adjunctive therapy for chronic hepatitis B. Previous studies have shown that a 6-month course of ribavirin alone or in combination with IFN-␣ modestly inhibit HBV replication with a variable rate of serum ALT normalization and HBeAg seroconversion.…”

Section: Discussionmentioning

confidence: 99%

Interferon α‐2b with and without ribavirin in the treatment of hepatitis B e antigen–positive chronic hepatitis B

et al. 2006

View full text Add to dashboard Cite

To study whether interferon (IFN) ␣ and ribavirin combination therapy has a beneficial effect for hepatitis B e antigen (HBeAg)-positive chronic hepatitis B, we enrolled 119 such patients in a randomized study. Fifty-nine patients received 5 million units of IFN-␣2b daily for 4 weeks followed by 5 million units three times a week for 28 weeks, plus 1,200 mg ribavirin daily. Sixty patients received the same dosage of IFN plus placebo. They were followed up for 24 weeks posttreatment, and 105 patients (88%) completed the entire course of 56 weeks. By intention-to-treat analysis, the rate of combined response (serum hepatitis B virus [HBV] DNA <2.5 pg/mL and HBeAg seroconversion) was 17% versus 25% between the IFN/ribavirin and IFN/placebo group, respectively, at the end of treatment (P ‫؍‬ .35) and 25% vs. 20% at the end of follow-up (P ‫؍‬ .32). Using quantitative real-time polymerase chain reaction assay, the log(10) reduction of serum HBV DNA was 1.05 ؎ 1.72 (mean ؎ SD) versus 1.29 ؎ 1.91 between the two groups at the end of treatment (P ‫؍‬ .49) and was 2.15 ؎ 2.15 versus 1.21 ؎ 2.48 at the end of follow-up (P ‫؍‬ .04). Prolonged observations in 83 patients suggested that the combined response was 29% (n ‫؍‬ 17) versus 20% (n ‫؍‬ 12) at 48 weeks after the end of treatment, respectively (P ‫؍‬ .17). The safety profile was similar, except that the IFN/ribavirin group had a higher risk of anemia (15% vs. 0%; P ‫؍‬ .002). In conclusion, for the treatment of HBeAg-positive chronic hepatitis B, adding ribavirin does not seem to increase the efficacy of IFN. (HEPATOLOGY 2006;43:742-749.)

show abstract

Section: Discussionmentioning

confidence: 99%

Interferon α‐2b with and without ribavirin in the treatment of hepatitis B e antigen–positive chronic hepatitis B

et al. 2006

View full text Add to dashboard Cite

show abstract

“…The same study demonstrated a predominant Th2 pattern with higher circulating levels of IL-6, IL-10 and TNF-α in HCV+ patients compared to HCV-patients, possibly reflecting a more active systemic inflammatory response. On the other hand, modifications in the Th1/Th2 ratio provoked by ribavirin treatment leading to an imbalance towards the Th1 response may be associated with a more favorable outcome regarding HCV therapy (24)(25)(26).…”

Section: Discussionmentioning

confidence: 99%

Effect of hepatitis C serology on C-reactive protein in a cohort of Brazilian hemodialysis patients

Nascimento

Bruchfeld

Suliman

et al. 2005

Braz J Med Biol Res

View full text Add to dashboard Cite

Hepatitis C (HCV) is not an uncommon feature in hemodialysis (HD) patients and may be a cause of systemic inflammation. Plasma cytokine interleukin-6 (IL-6) is mainly produced by circulating and peripheral cells and induces the hepatic synthesis of C-reactive protein (CRP), which is the main acute phase reactant. The aim of this study was to investigate the influence of HCV on two markers of systemic inflammation, serum CRP and IL-6, in HD patients. The study included 118 HD patients (47% males, age 47 ± 13 years, 9% diabetics) who had been treated by standard HD for at least 6 months. The patients were divided into two groups depending on the presence (HCV+) or absence (HCV-) of serum antibodies against HCV. Serum albumin (S-Alb), plasma high sensitivity CRP (hsCRP), IL-6, and alanine aminotransferase (ALT) were measured and the values were compared with those for 22 healthy controls. Median hsCRP and IL-6 values and hsCRP/IL-6 ratio were: 3.5 vs 2.1 mg/l, P < 0.05; 4.3 vs 0.9 pg/ml, P < 0.0001, and 0.8 vs 2.7, P < 0.0001, for patients and controls, respectively. Age, gender, S-Alb, IL-6 and hsCRP did not differ between the HCV+ and HCV-patients. However, HCV+ patients had higher ALT (29 ± 21 vs 21 ± 25 IU/l) and had been on HD for a longer time (6.1 ± 3.0 vs 4.0 ± 2.0 years, P < 0.0001). Moreover, HCV+ patients had a significantly lower median hsCRP/IL-6 ratio (0.7 vs 0.9, P < 0.05) compared to the HCV-group. The lower hsCRP/IL-6 ratio in HCV+ patients than in HCV-patients suggests that hsCRP may be a less useful marker of inflammation in HCV+ patients and that a different cut-off value for hsCRP for this population of patients on HD may be required to define inflammation.

show abstract

“…[80][81][82][83] In addition, ribavirin has been shown to downregulate Th2 mediated antibody production to HbeAg in mice. 84 Because ribavirin induced a Th1 cytokine profile it was possible that it might influence susceptibility to IIT in patients with HCV treated with the combination of IFN␣ and ribavirin. One recent study examined this possibility.…”

Section: Non-genetic Factorsmentioning

confidence: 99%

The clinical and physiological spectrum of interferon‐alpha induced thyroiditis

et al. 2006

View full text Add to dashboard Cite

Interferon-alpha (IFN␣) is a major treatment modality for several malignant and nonmalignant diseases, especially hepatitis C. Prospective studies have shown that up to 15% of patients with hepatitis C receiving IFN␣ develop clinical thyroid disease, and up to 40% were reported to develop thyroid antibodies. Some of these complications may result in discontinuation of interferon therapy. Thus, interferon induced thyroiditis (IIT) is a major clinical problem for patients receiving interferon therapy. IIT can be classified as autoimmune type and non-autoimmune type. I nterferons were discovered in the 1950Јs and were immediately recognized for their ability to render cells resistant to virus infection. 1 Interferons have been classified into two major groups, type I interferons and type II interferons, based on their capacity to bind to common receptor types. Type I interferons bind to a type I interferon receptor and include interferon-␣, interferon-␤, interferon-, and interferon-. 2 Type II interferons bind to a distinct type II receptor and include interferon-␥. 2 In addition to their antiviral properties, interferons have immunomodulatory, antiangiogenic, antiproliferative and antitumor activity, and act as important regulators of growth and differentiation. 3 Interferons work by directly binding to either type I or type II receptors. The cytoplasmic domains of the transmembrane glycoproteins are associated with members of the JAK family of kinases. They activate various signaling pathways, including the JAK-STAT pathway, the Crk-pathway, the IRS signaling pathway, and the MAP kinase pathway, which leads to signal transduction and subsequent activation or repression of specific genes. 3,4 More than twenty interferon-induced proteins have been identified. 5 Interferon-alpha (IFN␣) was the first cytokine to be reproduced by recombinant DNA technology and has emerged as a major therapeutic modality for several malignant and nonmalignant diseases. Among the diseases treated by IFN␣ are melanoma, renal cell carcinoma, hairy cell leukemia, Kaposi's sarcoma, and hepatitis B and C. 5 However, the most common prescription for IFN␣

show abstract

The antiviral compound ribavirin modulates the T helper (Th) 1/Th2 subset balance in hepatitis B and C virus-specific immune responses.

Abstract: Ribavirin is effective in combination therapies

Cited by 256 publications

References 42 publications

Interferon α‐2b with and without ribavirin in the treatment of hepatitis B e antigen–positive chronic hepatitis B

Interferon α‐2b with and without ribavirin in the treatment of hepatitis B e antigen–positive chronic hepatitis B

Effect of hepatitis C serology on C-reactive protein in a cohort of Brazilian hemodialysis patients

The clinical and physiological spectrum of interferon‐alpha induced thyroiditis

Contact Info

Product

Resources

About