title: Results of combination treatment with pegylated interferon and ribavirin in cirrhotic patients with hepatitis C infection.
abstract: BACKGROUND
  The treatment of hepatitis C patients with advanced cirrhotic liver disease remains challenging and data on the outcome of treatment for this patient group is limited.
  
  
  RESULTS
  Between September 2000 and August 2004, 61 cirrhotic patients started treatment with pegylated interferon and ribavirin (42 male, age range 29-69 years, 26 Asian). Forty-three (70%) patients were serum hepatitis C virus (HCV) RNA negative at the end of treatment and 24 (39%) achieved a sustained virological response (SVR). SVR was achieved for 35% (6/17) of patients with genotype 1, and for 39% (16/41) with genotype 3. Caucasians with genotype 3 demonstrated a higher cure rate (SVR 10/18 = 56%) than Asians (SVR 6/24 = 25%). Failure to achieve SVR was associated with lower platelet count, neutrophil count and albumin at baseline. Twenty patients suffered clinical or laboratory decompensation, five patients required hospitalization, and two patients died. Patients who experienced hepatic decompensation were older and had baseline characteristics associated with more advanced liver disease.
  
  
  CONCLUSIONS
  The treatment of patients with advanced HCV is challenging, although many treated patients achieve SVR. Significant toxicity is experienced and there is treatment-related mortality. This balance of efficacy and toxicity needs to be considered before commencing treatment.
authors.affiliation: Liver Unit, Queen Elizabeth Hospital, Birmingham, UK. bsrhoeroldt@doctors.org.uk
authors.forename: Barbara
authors.initials: B
authors.lastname: Höroldt
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Haydon
authors.forename: Katrina
authors.initials: K
authors.lastname: O'Donnell
authors.forename: Tracey
authors.initials: T
authors.lastname: Dudley
authors.forename: Peter
authors.initials: P
authors.lastname: Nightingale
authors.forename: David
authors.initials: D
authors.lastname: Mutimer
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D004361:Drug Tolerance; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D006526:Hepatitis C / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007370:Interferon Type I / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D011994:Recombinant Proteins; D012189:Retrospective Studies; D012254:Ribavirin / Q000008:administration & dosage* / Q000009:adverse effects; D012449:Safety
chemical_list: D000998:Antiviral Agents; D007370:Interferon Type I; D012367:RNA, Viral; D011994:Recombinant Proteins; D012254:Ribavirin