Pegylated IFN-alpha2a and ribavirin in the treatment of hepatitis C.
Chronic hepatitis C is a major worldwide health problem with an estimated prevalence of 1.6-2%. The prognosis of chronic hepatitis C depends on the rate of fibrosis progression which, over a 20-30-year time span, may determine the risk of developing cirrhosis and its complications, namely hepatocellular carcinoma, liver decompensation, hepatic encefalopathy and espohageal variceal bleeding. The only therapeutic measure able to halt this progressive process is HCV eradication by interferon (IFN)-based therapies. HCV clearance benefits patients with chronic hepatitis C, by preventing the progression to cirrhosis, as well as those with established cirrhosis, by effectively reducing the risk of liver-related complications. The latest innovation in anti-HCV treatment has been the pegylation of the IFN molecule through the attachment of one or more polyethylene glycols to the IFN molecule, drastically modifying the immunological, pharmacokinetic and pharmacodynamic properties of the drug. Following the demonstration of a more potent antiviral effect in terms of sustained virological response rates in Phase III randomized trials, pegylated IFN coupled with ribavirin has become the standard of care for chronic hepatitis C. Currently, two forms of pegylated IFN exist (alpha2a and alpha2b), which differ significantly in terms of pharmacokinetics and dynamics, is whether these peculiarities translate into different efficacy rates being still being debated.
AM & A Migliavacca Center for Liver Disease, First Division of Gastroenterology, Fondazione IRCCS, Maggiore Hospital, Mangiagalli e Regina Elena, University of Milan, Milan, Italy. alessio.aghemo@policlinico.mi.it
Alessio
A
Aghemo
Maria Grazia
MG
Rumi
Massimo
M
Colombo
D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D017326:Clinical Trials, Phase III as Topic; D004359:Drug Therapy, Combination; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D006526:Hepatitis C / Q000188:drug therapy* / Q000821:virology; D019698:Hepatitis C, Chronic / Q000188:drug therapy / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D012367:RNA, Viral / Q000097:blood; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a