title: Effectiveness of pegylated interferon and ribavirin in patients with liver HCV cirrhosis.
abstract: Clearance of HCV before transplantation could avoid recurrence of hepatitis C in the liver allograft, thereby improving graft and patient survival. We report our experience with combined therapy for patients with HCV cirrhosis, including 12 patients with biopsy-proven liver cirrhosis (n = 7) or previous cirrhotic complications (n = 5). The Child-Pugh score was A in eight patients and B in four. Two patients had hepatocellular carcinoma. Genotype distribution was 1a (n = 2), 1b (n = 8) or 3 (n = 1). Patients received peginterferon alpha2b (1.5 microg/kg once weekly) and ribavirin (10.6 g/kg per day) for 48 weeks (genotype 1) or 24 weeks (genotype 3). Twenty-one months after beginning therapy all the patients remained alive; three have undergone liver transplantation. In one patient treatment was discontinued after 2 months due to cachexia. End-of-treatment virologic response was achieved in five patients (41.7%) and sustained virologic response in three patients (25%). Patients who cleared the virus had negative PCR 4 weeks after beginning therapy. All patients had adverse events. The most common clinical events were asthenia, weight loss, fever, and anorexia. Infectious complications resolved in three patients (25%). Hematologic events were common. Seven of 11 patients (63.6%) who completed therapy required dose reduction. We conclude that therapy with peginterferon and ribavirin in patients with HCV cirrhosis has a similar effectiveness to previous treatments. A virologic response 1 month after the beginning of therapy could be a main predictor of a sustained response.
authors.affiliation: Liver Transplant Unit, Hospital Puerta de Hierro, Madrid, Spain. josemariamoren@mixmail.com
authors.forename: J M
authors.initials: JM
authors.lastname: Moreno Planas
authors.forename: E
authors.initials: E
authors.lastname: Rubio González
authors.forename: E
authors.initials: E
authors.lastname: Boullosa Graña
authors.forename: M
authors.initials: M
authors.lastname: Fernández Ruiz
authors.forename: M
authors.initials: M
authors.lastname: Jiménez Garrido
authors.forename: J L
authors.initials: JL
authors.lastname: Lucena de la Poza
authors.forename: F
authors.initials: F
authors.lastname: Martínez Arrieta
authors.forename: C
authors.initials: C
authors.lastname: Molina Miliani
authors.forename: V
authors.initials: V
authors.lastname: Sánchez Turrión
authors.forename: V
authors.initials: V
authors.lastname: Cuervas-Mons Martínez
mesh_terms: D000328:Adult; D000368:Aged; D004359:Drug Therapy, Combination; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000209:etiology / Q000821:virology; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b