title: [Extrahepatic manifestations of chronic hepatitis C and their influence on response to treatment with pegylated interferon alfa-2a and ribavirin].
abstract: BACKGROUND
  Thirty to 50% of patients with chronic hepatitis C (CHC) have one or more extrahepatic manifestations (EHMs) of hepatitis C virus (HCV) infection.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the frequency of EHMs and to investigate the efficacy of pegylated interferon (Peg-IFN)-alpha-2a plus ribavirin therapy in patients with HCV-related EHMs.
  
  
  METHODS
  The study included 280 patients suffering from CHC and treated with Peg-IFN-alpha-2a and ribavirin.The patients were divided in two groups according to presence or absence of EHMs. We evaluated virological response to antiviral therapy.
  
  
  RESULTS
  One or more EHMs were found among 27.9% of patients. Most frequently they had rheumatoid factor in serum (12.5%), organ-nonspecific antibodies ANA and AGMA (12.4%), thyroid hormone disorders (9.3%), vasculitis (5.7%), diabetes mellitus (4.65%), glomerulonephritis (0.71%), and porphyria cutanea tarda (0.36%). Among the patients with EHMs there was 52.6% of females vs. 30.2% of females in the group of patients without EHMs (p=0.001). HCV genotypes 1 and 4 had 85.9% patients with EHMs vs. 58.4% of patients without EHMs (p=0.000). Progressive fibrosis and cirrhosis were more frequently recorded in the EHM group of patients (32% vs. 23.2%), but without statistically significant difference (p=0.532). Serious adverse events of Peg-IFN-alpha-2a and ribavirin were statistically significantly recorded among the patients with EHMs (46.1% vs. 12.9%; p=0.000). Sustained virological response among the patients with and without EHMs rated 56.9% and 70.8% respectively (p=0.125).
  
  
  CONCLUSIONS
  Patients with CHC and EHMs treated with combined Peg-IFN-alpha-2a and ribavirin experience handling difficulties, more often have serious adverse events, while successful outcome is achieved in about 50% of patients.
authors.forename: Milotka
authors.initials: M
authors.lastname: Fabri
authors.forename: Maja
authors.initials: M
authors.lastname: Ruzić
authors.forename: Dajana
authors.initials: D
authors.lastname: Lendak
authors.forename: Tomislav
authors.initials: T
authors.lastname: Preveden
authors.forename: Izabella
authors.initials: I
authors.lastname: Fabri
authors.forename: Vedrana
authors.initials: V
authors.lastname: Petrić
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage; D001323:Autoantibodies / Q000097:blood; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D005260:Female; D016174:Hepacivirus / Q000187:drug effects*; D019698:Hepatitis C, Chronic / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology; D006629:Hirudins; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011994:Recombinant Proteins / Q000008:administration & dosage; D012217:Rheumatoid Factor / Q000097:blood; D012254:Ribavirin / Q000008:administration & dosage*; D013963:Thyroid Hormones / Q000097:blood
chemical_list: D000998:Antiviral Agents; D001323:Autoantibodies; D006629:Hirudins; D016898:Interferon-alpha; D011994:Recombinant Proteins; D013963:Thyroid Hormones; C115295:beta-naphthylsulfonyl-(d-Pip)-Ada-Abu-DFEEIPEEYLQ-OH-AcOH; D011092:Polyethylene Glycols; D012254:Ribavirin; D012217:Rheumatoid Factor; C100416:peginterferon alfa-2a