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pegylated interferon plus ribavirin for genotype Ib chronic hepatitis C in Japan

World Journal of Gastroenterology 2008年第47期14卷 7225-7230页

作者： Takayuki Kogure Yoshiyuki Ueno Koji Fukushima Futoshi Nagasaki Yasuteru Kondo Jun Inoue Yasunori Matsuda Eiji Kakazu Takeshi Yamamoto Hiroyoshi Onodera Yutaka Miyazaki Hiromasa Okamoto Takehiro Akahane Tomoo Kobayashi Yutaka Mano Takao Iwasaki Motoyasu Ishii Tooru Shimosegawa Division of Gastroenterology Tohoku University HospitalSendai 980-8574Japan Department of Gastroenterology Tohoku Rosai HospitalSendai 980-8574Japan Department of Gastroenterology Miyagi Cancer CenterNatori 981-1293Japan Department of Internal Medicine Tohoku Kosai HospitalSendai 980-0803Japan Department of Internal Medicine Shirakawa Kosei General HospitalShirakawa 961-0005Japan Department of Gastroenterology Ishinomaki Municipal HospitalIshinomaki 986-0835Japan Department of Gastroenterology Osaki Citizen HospitalFurukawa 989-6183Japan Department of Gastroenterology Sendai Medical CenterSendai 983-8520Japan Department of Internal Medicine Miyagi Social Insurance HospitalSendai 981-1103Japan

AIM:To evaluate the efficacy of pegylated interferon α-2b(peg-IFNα-2b) plus ribavirin(RBV) therapy in Japanese patients with chronic hepatitis C(CHC) genotype Ib and a high viral ***:One hundred and twenty CHC patients(58.3% male) who received peg-IFNα-2b plus RBV therapy for 48 wk were *** virological response(SVR) and clinical parameters were ***:One hundred(83.3%) of 120 patients completed 48 wk of treatment.53 patients(44.3%) achieved *** virological response(EVR) and end of treatment response(ETR) rates were 50% and 73.3%,*** clinical parameters(SVR vs non-SVR) associated with SVR,ALT(108.4 IU/L vs 74.5 IU/L,P = 0.063),EVR(76.4% vs 16.4%,P 56 years),SVR in females was significantly lower than that in males(17% vs 50%,P = 0.0262).EVR and adherence to Peg-IFN were demonstrated to be the main factors associated with ***:Peg-IFNα-2b plus RBV combination therapy demonstrated good tolerability in Japanese patients with CHC and resulted in a SVR rate of 44.3%.Treatment of elderly female patients is still challenging and maintenance of adherence to peg-IFNα-2b is important in improving the SVR rate.

关键词： Chronic hepatitis C pegylated interferon Ribavirin

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pegylated interferon α-2b plus ribavirin for older patients with chronic hepatitis C

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World Journal of Gastroenterology 2010年第35期16卷 4400-4409页

作者： Mosaburo Kainuma Norihiro Furusyo Eiji Kajiwara Kazuhiro Takahashi Hideyuki Nomura Yuichi Tanabe Takeaki Satoh Toshihiro Maruyama Makoto Nakamuta Kazuhiro Kotoh Koichi Azuma Junya Shimono Shinji Shimoda Jun Hayashi Department of General Internal Medicine Kyushu University Hospital Department of Internal Medicine Nippon Steel Yawata Memorial Hospital Department of Medicine Hamanomachi Hospital The Center for Liver Disease Shin-Kokura Hospital Department of Medicine Fukuoka City HospitalYoshiduka-honmachi Center for Liver Disease National Hospital Organization Kokura Medical Center Department of Medicine Kitakyushu Municipal Medical Center Department of Gastroenterology Kyushu Medical CenterNational Hospital Organization Department of Medicine and Bioregulatory Science Graduate School of Medical ScienceKyushu University Department of Medicine and Clinical Science Graduate School of Medical SciencesKyushu University Saiseikai Yahata General Hospital Harunomachi Department of Medicine and Biosystemic Science Graduate School of Medical ScienceKyushu University

AIM:To analyze the efficacy and safety of a combination therapy of pegylated interferon(PEG-IFN) α-2b plus ribavirin(RBV) in older Japanese patients(65 years or older) infected with hepatitis C virus(HCV).METHODS:This multicenter study included 938 patients with HCV genotype 1 who received 1.5 μg/kg per week PEG-IFN α-2b plus RBV 600-1000 mg/d for 48 wk and 313 HCV genotype 2 patients who received this treatment for 24 ***:At 24 wk after the end of combination therapy,the overall sustained virological response(SVR) for genotypes 1 and 2 were 40.7% and 79.6%,*** SVR rate decreased signif icantly with age in each genotype,and was markedly reduced in genotype 1(P<0.001).Moreover,the SVR was significantly higher in patients with genotype 1 who were less than 65 years(47.3% of 685) than in those 65 years or older(22.9% of 253)(P<0.001) and was higher in patients with genotype 2 who were less than 65 years(82.9% of 252) than in those 65 years or older(65.6% of 61)(P=0.004).When patients received a dosage at least 80% or more of the target dosage of PEG-IFN α-2b and 60% or more of the target dosage of RBV,the SVR rate significantly increased to 66.5% in patients less than 65 years and to 45.2% in those 65 years or older(P<0.001).Adverse effects resulted in treatment discontinuation more often in patients with genotype 1(14.4%) than in patients with genotype 2(7.3%),especially by patients 65 years or older(24.1%).CONCLUSION:PEG-IFN α-2b plus RBV treatment was effective in chronic hepatitis C patients 65 years or older who completed treatment with at least the minimum acceptable treatment dosage.

关键词： Hepatitis C virus Gerontology pegylated interferon Ribavirin

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Psychiatric side effects of pegylated interferon alfa-2b as compared to conventional interferon alfa-2b in patients with chronic hepatitis C

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World Journal of Gastroenterology 2005年第12期11卷 1769-1774页

作者： Michael R Kraus Arne Sch(a|¨)fer Herbert Csef Michael Scheurlen Medizinische Poliklinik

AIM: To assess systematically the spectrum and extent of depressive symptoms comparing patient groups receiving peginterferon or conventional ***: Ninety-eight patients with chronic hepatitis C and interferon-based therapy (+ribavirin) were consecutively enrolled in a longitudinal study. Patients were treated with conventional interferon alfa-2b (48/98patients; 5 MIU interferon alfa-2b thrice weekly) or peginterferon alfa-2b (50/98 patients; 80-150 μgpeginterferon alfa-2b) in combination with weight-adapted ribavirin (800-1 200 mg/d). Repeated psychometric testing was performed before, three times during and once after antiviral therapy: Depression was evaluated by the Hospital Anxiety and Depression Scale (HADS), anger/hostility by the Symptom Checklist-90 Items Revised (SCL-90-R).RESULTS: Therapy with pegylated interferon alfa-2bproduces comparable scores for depression (ANOVA:P = 0.875) as compared to conventional *** of depression scores were even higher and cases of clinically relevant depression were frequent during therapy with peginterferon. Scores for anger/hostility were comparable for both therapy ***: Our findings suggest that the extent and frequency of depressive symptoms in total are not reduced by peginterferon. Monitoring and management of neuropsychiatric toxicity especially depression have to be considered as much as in antiviral therapy with unmodified interferon.

关键词： pegylated interferon Hepatitis C Side effects Depression interferon alfa

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Early Serum HBsAg Kinetics as Predictor of HBsAg Loss in Patients with HBeAg-Negative Chronic Hepatitis B after Treatment with pegylated interferonα-2a

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Virologica Sinica 2021年第2期36卷 311-320页

作者： Minghui Li Lu Zhang Yao Lu Qiqi Chen Huihui Lu Fangfang Sun Zhan Zeng Gang Wan Linqing Zhao Yao Xie Department of Hepatology Division 2 Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Department of Hepatology Division 2 Peking University Ditan Teaching HospitalBeijing 100015China Department of Biostatistics Beijing Ditan HospitalCapital Medical UniversityBeijing 100015China Laboratory of Virology Capital Institute of Pediatrics Beijing 100020China

Hepatitis B surface antigen(HBsAg)loss is an ideal treatment endpoint for patients with chronic hepatitis B(CHB).We investigated the predictive value of on-treatment HBsAg levels for HBsAg loss in hepatitis B e antigen(HBe Ag)-negative CHB patients who received 120-week PEG-IFNα-2a *** HBV DNA,HBsAg,and anti-HBs levels were assayed at baseline and every 3 months during the *** 81 patients,12 achieved HBsAg loss,20 achieved HBsAg\100 IU/mL,and 49 maintained HBs Ag C 100 IU/*** loss rate was only 3.7%at 48 weeks,while it reached to 11.1%and 14.8%after treatment of 96 weeks and 120 *** cutoff HBs Ag levels at 12 weeks predicting HBsAg loss at 96 weeks and 120 weeks of treatment were 400 IU/mL and 750 IU/mL,with AUC 0.725 and 0.722,positive predictive value(PPV)29.41%and 30.56%,and negative predictive value(NPV)93.75%and 97.78%,*** cutoff HBsAg levels at 24 weeks predicting HBsAg loss at 96 weeks and 120 weeks of treatment were 174 IU/m L and 236 IU/mL respectively,with AUC 0.925 and 0.922,PPV 40.0%and 46.15%,and both NPV 100%.The predictive ability of the cutoff HBsAg levels at 24 weeks was better than that at 12 weeks for HBs Ag loss at either 96 or 120 weeks(χ~2=3.880,P=0.049 andχ~2=4.412,P=0.036).These results indicate that extended therapy is critical to HBsAg loss in HBe Ag-negative CHB patients during PEG-IFN treatment,and the HBsAg level at 24 weeks can be used to predict HBsAg loss during tailoring PEG-IFN therapy.

关键词： Chronic hepatitis B(CHB) Hepatitis B surface antigen(HBsAg) pegylated interferon HBsAg loss HBeAg negative

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Acute inflammatory demyelinating polyneuropathy associated with pegylated interferon α 2a therapy for chronic hepatitis C virus infection

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World Journal of Gastroenterology 2008年第2期14卷 318-321页

作者： Vijay Khiani Thomas Kelly Adeel Shibli Donald Jensen Smruti R Mohanty Department of Medicine Case Western Reserve University Cleveland OH United States Department of Neurology The University of ChicagoChicago IL United States Department of Medicine Weiss Memorial Hospital Chicago IL United States Department of Medicine Center for Liver Diseases The University of Chicago Chicago IL United States

The combination of pegylated interferon (Peg-IFN) and ribavirin is the standard of care for chronic hepatitis C virus (HCV) infection treatment. In general, common side effects related to this combination therapy are mild and are very well tolerated. However, peripheral neuropathy including demyelinating polyneuropathy related to Peg-IFN is extremely rare. We present the first case of an acute inflammatory demyelinating polyneuropathy (AIDP) associated with Peg-IFN-α 2a (Pegasys) after 16 wk of a combination therapy with Pegasys and ribavirin in a 65-year-old woman with chronic HCV infection. She developed tingling, numbness, and weakness of her upper and lower extremities and was hospitalized for acute neurological deficits. Her clinical course, neurological findings, an electromyogram (EMG), nerve conductions studies (NCS), muscle biopsy, and a sural nerve biopsy were all consistent with AIDP likely related to Pegasys use. The patient recovered completely with the use of intravenous immunoglobulin (IVIG) including physical therapy and neurological rehabilitation. It is very important that gastroenterologists and/or hepatologists recognize this rare neurological complication related to Peg-IFN treatment very early, since it requires a prompt discontinuation of therapy including an immediate referral to a neurologist for the confirmation of diagnosis, management, and the prevention of long-term neurological deficits.

关键词： Neuropathy pegylated interferon Pegasys

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Real world experience with pegylated interferon and ribavirin in Hepatitis C Genotype 1 population with favourable IL28B polymorphism

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Gastroenterology Report 2017年第3期5卷 208-212,I0002页

作者： Victoria Ekstrom Rajneesh Kumar Yi Zhao Mei Ling Yee Cynthia Sung Dorothy Toh Poh Yen Loh Jessica Tan Eng Kiong Teo Wan Cheng Chow Department of Gastroenterology and Hepatology Singapore General HospitalSingapore Department of Clinical Translational Research Singapore General HospitalSingapore Department of Pharmacy Singapore General HospitalSingapore Health Products Regulation Group Health Sciences AuthoritySingapore Emerging Infectious Disease Programme Duke-NUS Medical SchoolSingapore Department of Gastroenterology and Hepatology Changi General HospitalSingapore

Background and aim:Conventional hepatitis C treatment using pegylated interferon(PEG-IFN)and ribavirin is associated with significant side ***28B polymorphism can predict response to treatment,with CC genotype having a better *** gene deficiency protects against clinically significant anaemia induced by *** purpose of this study was to determine IL28B polymorphismand ITPA variation among hepatitis C genotype 1 patients who have undergone therapy with PEG-IFN and ribavirin and their association with sustained viral response(SVR).Methods:All hepatitis C genotype 1 patients who had been treated with PEG-IFN and ribavirin over the past 10 years were identified by available medical records and were contacted by letter of invitation to participate in the *** samples for IL28B and ITPA genotyping were *** records were reviewed for verification of treatment response,development of anaemia and if treatment reduction was required during the ***:A total of 61 patients with hepatitis C genotype 1 were treated with PEG-IFN and ribavirin,of whom 42 agreed to participate in the *** age was 45.6±12.9 years at time of treatment,and 83.3%of patients ***-three(78.6%)had IL28B CC genotype,of whom 25(75.8%)obtained SVR compared with only 3 of 9(33.3%)non C/C genotype patients who achieved SVR(P=0.041).Eleven(26.1%)patients had ITPA AC genotype,and 30(71.4%)had CC *** was no statistically significant difference between ITPA AC and CC genotypes in predicting clinically significant anaemia(45.5%vs 63.3%,P=0.302).Even among patients who developed anaemia,70.8%stillmanaged to achieve *** reduction also had no impact on ***:Hepatitis C genotype 1 patients should be informed of the response rate for treatment with PEG-IFN and ribavirin in a population with favourable IL28B genotype before consideration of newer therapeutic options.

关键词： hepatitis C pegylated interferon IL28B polymorphism sustained viral response

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Co-treatment with pegylated interferon alfa-2a and entecavir for hepatitis D: a randomized trial

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World Journal of Hepatology 2016年第14期8卷 625-631页

作者： Zaigham Abbas Mohammad Sadik Memon Muhammad Amir Umer Minaam Abbas Lubna Shazi Department of Gastroenterology Ziauddin University Hospital Department of Medicine Orthopedic and Medical Institute Liver Stomach Clinic Zamzama Asian Institute of Medical Sciences

AIM: To investigate the efficacy of pegylated interferon alfa(PEG-IFNα) therapy with and without entecavir in patients with chronic hepatitis D. METHODS: Forty hepatitis D virus(HDV) RNA positive patients were randomized to receive either PEG-IFNα-2a 180 μg weekly in combination with entecavir 0.5 mg daily(n = 21) or PEG-IFNα alone(n =19). Patients who failed to show 2 log reduction in HDV RNA level at 24 wk of treatment, or had detectable HDV RNA at 48 wk of therapy were considered as treatment failure. Treatment was continued for 72 wk in the rest of the patients. All the patients were followed for 24 wk post treatment. Intention to treat analysis was ***: The mean age of the patients was 26.7 ± 6.8 years, 31 were male. Two log reduction in HDV RNA levels at 24 wk of therapy was achieved in 9(43%) patients receiving combination therapy and 12(63%) patients receiving PEG-IFNα alone(P = 0.199). Decline in hepatitis B surface antigen(HBs Ag) levels was insignificant. At the end of treatment, HDV RNA was negative in 8 patients(38%) receiving combination therapy and 10 patients(53%) receiving PEG-IFNα-2a alone. Virological response persisted in 7(33%) and 8(42%) patients, respectively at the end of the 24 wk follow-up period. One responder patient in the combination arm lost HBs Ag and became hepatitis B surface antibody positive. Six out of 14 baseline hepatitis B e antigen reactive patients seroconverted and four of these seroconverted patients had persistent HDV RNA ***: Administration of PEG-IFNα-2a with or without entecavir, resulted in persistent HDV RNA clearance in 37% of patients. The addition of entecavir did not improve the overall response.

关键词： Hepatitis D Entecavir Hepatitis B surface antigen pegylated interferon Hepatitis D virus RNA Treatment

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Combination of pegylated interferon and lamivudine for patients with chronic hepatitis B who have failed treatment

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Hepatobiliary & Pancreatic Diseases International 2006年第3期5卷 374-380页

作者： Shiv K.Sarin Manoj Kumar Syed Hissar Barjesh C.Sharma Department of Gastroenterology G.B.Pant Hospital New Delhi-110002India

BACKGROUND: Treatment of chronic hepatitis B (CHB) alone with interferon or lamivudine alone or in combination is effective in only a small proportion of patients. Treatment of patients in whom antiviral therapy fails is challenging. This study was made to determine the efficacy of combined pegylated interferon alpha (peg-IFN) and lamivudine in patients with CHB who had failed to respond to antiviral treatment. METHODS: Twenty patients with CHB proven by liver biopsy, with ALT levels >1.5×ULN,HBV DNA levels>141 500 copies/ml, and previous treatment failure with an adequate regimen were treated with a combination of peg-IFN 1.5μg/kg and lamivudine 100 mg/day for 52 weeks and followed up for a further 24 weeks. Biochemical response was defined as normalization of ALT and DNA response as HBV DNA<141 500 copies/ml. Secondary efficacy measures included HBsAg loss, HBeAg loss and appearance of anti-HBe (in cases of HBeAg-positive patients). RESULTS: Twenty patients were treated, of whom 16 were HBeAg positive. At 52 weeks, normal ALT was seen in 10 (50%) (8 of 16 HBeAg+ and 2 of 4 HBeAg), HBV DNA response in 5 (25%) (5 of 16 in HBeAg+ and none in HBeAg-), and HBeAg loss with appearance of anti-HBe in 5 (31.3%) of the 16 HBeAg positive patients. At 76 weeks, 8 (80%) of the 10 patients with normal ALT at 52 weeks relapsed, with normal ALT only in 2 (10%) (1 of 16 HBeAg+ and 1 of 4 HBeAg-), and all 5 patients who had a DNA response at 52 weeks relapsed at 76 weeks and had no DNA response. HBeAg loss with appearance of anti-HBe was seen in 1 (6.3%) of 16 HBeAg-positive patients. None of the patients lost HBsAg. CONCLUSIONS: The combination of peg-IFN and lamivudine for 52 weeks is not effective for treatment of CHB patients with a failed treatment. New treatment strategies need to be developed.

关键词： chronic hepatitis B pegylated interferon lamivudine non-responder

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Treatment of Chronic Viral Hepatitis with pegylated interferon in Ivory Coast

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Open Journal of Gastroenterology 2016年第3期6卷 65-74页

作者： Henriette Ya Kissi Anzouan-Kacou Aboubacar Demba Bangoura Djenabou Diallo Yacouba Adéhouni Adjeka Stanislas Doffou Hartrydt Dimitri Kouamé Alassan Kouamé Mahassadi Mamert Fulgence Yao Bathaix Alain Koffi Attia Aya Thérèse Ndri-Yoman Hepatogastroenterology Unit Yopougon Teaching Hospital Yopougon Ivory Coast Pharmacy Unit Yopougon Teaching Hospital Yopougon Ivory Coast

Background: In the Ivory Coast, chronic infection by hepatitis B and C virus is the leading cause of cirrhosis and hepatocellular carcinoma. The absence of universal health coverage makes the treatment inaccessible to all. Objectives: To assess the efficacy of pegylated interferon in clinical practice in patients with chronic viral hepatitis B and C and determine the hematologic side effects. Patients and Methods: A descriptive retrospective study from January 2012 to November 2013 on a cohort of patients chronic carriers of hepatitis B virus (n = 11) treated with pegylated interferon to 180 mcg per week and hepatitis C virus (n = 30) treated with a combination therapy associating pegylated interferon to 180 mcg per week and Ribavirin assayed according to the genotype. Results: Out of 1860 patients seen in hepatogastroenterology consultation 422 had viral hepatitis B or C that is a prevalence of 22.7% and 41 patients were treated (9.7%) by pegylated interferon. Among these 41 patients mentioned earlier, 30 had HCV (73.17%) with a case of HIV + HVC co-infection, 11 patients had HBV (26.83%) including 3 cases of HBV + HDV co-infection. Patients’ age ranged from 24 - 69 years with an average of 49.2 ± 12.2 years including 46.5 years for HBV and 51.9 years for HCV. The sex ratio was 1.56. The original transaminases were on average 93.37 IU/l for AST and 110.47 for ALT. The average RNA HCV was 1,685,331 IU/ml and the DNA HBV 33,312,767 IU/ml. Patients with HCV were of genotype 1 in 56.66%, genotype 2 in 40% and one case of genotype 4 (3.34%) from Central Africa. Fibrosis score at institution of treatment was significant (≥A2 and/or ≥F2) in 86.9% of cases of Fibrotest®, 100% of cases of Fibrometer®. We observed 48.8% of neutropenia pegylated interferon and Ribavirin. For HBV there were 3 partial responses, 3 responders including 1 HBV + HDV co-infected non responder to H

关键词： HBV HCV pegylated interferon Ribavirine Africa

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Predictive Value of Serum pgRNA on HBeAg Clearance in Patients with Chronic Hepatitis B with Low HBeAg Levels Treated with pegylated interferon

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Journal of Clinical and Nursing Research 2023年第4期7卷 165-169页

作者： Yu Li Yifei Lyu Feng-Yu Xi Ying Gao Department of Infectious Diseases Shaanxi Provincial People’s HospitalXi’an 710068Shaanxi ProvinceChina Department of Gastroenterology Shaanxi Provincial People’s HospitalXi’an 710068Shaanxi ProvinceChina Department of Clinical Laboratory Shaanxi Provincial People’s HospitalXi’an 710068Shaanxi ProvinceChina Department of Hematology Shaanxi Provincial People’s HospitalXi’an 710068Shaanxi ProvinceChina

Objective:To study the predictive value of serum pregenomic RNA(pgRNA)on HBeAg clearance in patients with chronic hepatitis B with low HBeAg levels during pegylated interferon ***:Twenty chronic hepatitis B patients with HBeAg positive and quantitativepegylated interferon therapy for 48-96 weeks and were followed up in the outpatient clinic after *** patients were then divided into groups based on whether their HbeAg turned *** predictive ability of each indicator for HBeAg negative conversion was evaluated in the HBeAg negative group and the HBeAg positive ***:The results of logistic regression analysis suggested that pgRNA and HBcrAg were better indicators for predicting the clearance of HBeAg after ***:For patients with chronic hepatitis B with low HBeAg levels,pgRNA is a good indicator in predicting HBeAg clearance during pegylated interferon therapy.

关键词： Serum pgRNA pegylated interferon Low HBeAg level Chronic hepatitis B HBeAg clearance Predictive value

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