Hepatitis C virus cirrhosis: prolonged sustained virological response in a patient after low-dose antiviral treatment.
Hepatitis C virus (HCV) infection is the most frequent cause of chronic liver disease in the western world. The ''gold standard'' treatment of chronic HCV infection currently involves the administration of pegylated interferon alpha (PEG-IFN) and ribavirin. The success of this therapy is demonstrated by sustained virological responses (SVR). Randomized trials and practice guidelines have reported that compensated HCV cirrhosis is an indication for treatment with PEG-IFN and ribavirin, not only to obtain SVR but also to increase survival and to reduce the development of cirrhotic sequelae. In particular, the literature has reported that antiviral treatment was associated with histological improvement of fibrosis in cirrhotic patients with SVR. Recently, the same authors have evaluated the efficacy and safety of different doses of antiviral treatment in patients with chronic HCV infection. The use of interferon has been limited due to associated side effects, particularly in cirrhotic patients. Consequently, therapeutic decisions should be made on an individual basis. The Authors report a case of a patient with compensated HCV liver cirrhosis, with associated severe thrombocytopenia and oesophageal varices, in which the administration of antiviral therapy at a dose lower than the therapeutic ''gold standard'' has achieved SVR and consequently improved clinical status.
Abenavoli
L
L
Institute of Internal Medicine, Policlinico A. Gemelli, Catholic University of Rome, Largo Gemelli 8, Rome, Italy. l.abenavoli@yahoo.it
De Maria
V
V
De Siena
M
M
Di Salvo
S
S
Giancotti
F
F
Gravina
T
T
Abenavoli
S M
SM
D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage*; D006526:Hepatitis C / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D008103:Liver Cirrhosis / Q000821:virology*; D008297:Male; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage*
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a