Treatment with interferon-α and ribavirin in patients with chronic hepatitis C and persistently normal ALT levels

Erhardt, Andreas; Maschner-Olberg, Andrea; Häussinger, Dieter

doi:10.1016/s0168-8278(00)81028-4

Cited by 8 publications

(2 citation statements)

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“…The sustained viral response rate in this study of patients with histologically mild chronic hepatitis C is similar to those obtained in the two landmark studies of interferon and ribavirin combination therapy [6,7], in which no distinction based on histology, was made. Although no direct comparison was made to patients with progressive liver disease, this study demonstrates that the treatment outcome in patients with histologically mild liver disease is likely to be as good as those with progressive fibrosis and is in agreement with two recent smaller studies that found equivalent response rates in patients with normal aminotransferase levels [14,15].…”

Section: Discussionsupporting

confidence: 89%

Treatment of histologically mild hepatitis C virus infection with interferon and ribavirin: a multicentre randomized controlled trial

Wright

Forton

Main

et al. 2005

Journal of Viral Hepatitis

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Current guidelines advocate no treatment for patients with histologically mild hepatitis C virus (HCV) infection. This was a UK multicentre randomized controlled trial comparing alpha-interferon (3 MU thrice weekly) + ribavirin (1000-1200 mg/day) for 48 weeks with no treatment in treatment naive, adult patients with histologically mild chronic HCV infection. The aim was to compare benefits, safety and efficacy of combination therapy with alpha-interferon 2b and ribavirin for 48 weeks with no treatment (current standard management) in this patient group. In the treatment group 32 of 98 (33%) patients achieved a sustained virological response (SVR). Patients infected with genotype 1 had a lower SVR than those infected with genotype non-1 (18% vs 49% P = 0.02). No patients who failed to achieve a 2-log drop in viral load at 12 weeks achieved SVR. Improvements in quality of life 24 weeks postcessation of therapy compared with baseline using the SF-36 questionnaire measures were observed in the treated group. For patients with mild HCV infection with viral genotype non-1, the results are sufficiently good to suggest that therapeutic decisions should no longer be biopsy-driven. For patients infected with genotype 1, a liver biopsy is still indicated as the low chance of SVR is outweighed by an unacceptable burden of side-effects. Patients who fail to respond by 12 weeks of therapy should have their treatment curtailed early.

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Section: Discussionsupporting

confidence: 89%

Treatment of histologically mild hepatitis C virus infection with interferon and ribavirin: a multicentre randomized controlled trial

Wright

Forton

Main

et al. 2005

Journal of Viral Hepatitis

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“…Eine dauerhafte Virusunterdrückung wird mit einer Standard-IFN-/PEG-IFN-Ribavirin-Kombinationsbehandlung bei etwa 40% der Patienten erreicht (7,15,31).…”

Section: Normwertige Transaminasenunclassified

Aktuelle Therapie der Hepatitis-C-Virus-Infektion

Lörke

Avcı²,

Erhardt³

et al. 2005

Dtsch med Wochenschr

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New strategies have led to better results in the treatment of HCV infection during the last few years. At present the recommended treatment for patients with chronic hepatitis C is a combination of pegylated interferon and ribavirin. The sustained virological response rate of this combination therapy is 42 - 48 % for patients with genotype 1 after a course of 48 weeks and 80 % for patients with genotype 2 or 3 after a course of 24 weeks. New nucleoside analogs may lead to a better tolerance and better outcomes. A new approach is the long term monotherapy with pegylated interferon in order to reduce the progression of fibrosis and the incidence of cirrhotic complications. At present the effectivity of protease inhibitors and of a therapeutic immunisation with the E1 envelope protein of the hepatitis C virus are being examined. Because the optimal treatment strategy for patients with an acute hepatitis C infection is still unclear, these patients should be included in clinical studies.

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