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Peginterferon alfa-2a is associated with elevations in alanine aminotransferase at the end of treatment in chronic hepatitis C patients with sustained virologic response.

AbstractBACKGROUND:
The purpose of this study was to investigate the incidence and demographic/clinical factors of alanine aminotransferase (ALT) abnormalities at the end of treatment (EOT) in chronic hepatitis C (CHC) patients with sustained virologic response (SVR).
METHODS AND FINDINGS:
Seven hundred naïve CHC patients who underwent combination treatment between January 2003 and December 2010 were included in the study. The patients with SVR and serum ALT>upper limit of normal (ULN) at the EOT were further analyzed. The effects of clinical characteristics, treatment regimen, and virologic variables were evaluated by logistic regression. Of the 700 included patients, 488 (69.7%) achieved an SVR after treatment, and 235 (33.6%) had serum ALT levels>ULN at the EOT. Of those 488 patients, 137 (28.1%) had abnormal ALT values at the EOT. A multivariate analysis showed that the occurrence of ALT abnormalities at the EOT was significantly associated with pegylated interferon (PEG-IFN) alfa-2a (odds ratio [OR], 2.24; 95% confidence interval [CI], 1.45-3.45; P<0.001), baseline fatty liver (OR, 1.76; 95% CI, 1.16-2.76; Pā€Š=ā€Š0.007), and baseline liver cirrhosis (OR, 2.35; 95% CI, 1.35-4.09; Pā€Š=ā€Š0.002).
CONCLUSIONS:
Use of PEG-IFN-alfa-2a, fatty liver, and cirrhosis are important factors associated with EOT-ALT abnormality in CHC patients receiving combination therapy that achieve an SVR. PEG-IFN-alfa-2a-related EOT-ALT elevation will become normal at the end of follow-up, but fatty liver and cirrhosis-related ALT elevation will not be resolved.
AuthorsChih-Wei Tseng, Chi-Yi Chen, Ting-Tsung Chang, Shinn-Jia Tzeng, Yu-Hsi Hsieh, Tsung-Hsing Hung, Ching-Chih Lee, Shu-Fen Wu, Kuo-Chih Tseng
JournalPloS one (PLoS One) Vol. 9 Issue 6 Pg. e100207 ( 2014) ISSN: 1932-6203 [Electronic] United States
PMID24937007 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
Chemical References
  • Antiviral Agents
  • Interferon-alpha
  • RNA, Viral
  • Recombinant Proteins
  • peginterferon alfa-2a
  • Polyethylene Glycols
  • Alanine Transaminase
Topics
  • Alanine Transaminase (metabolism)
  • Antiviral Agents (therapeutic use)
  • Cross-Sectional Studies
  • Fatty Liver (drug therapy, enzymology, virology)
  • Female
  • Follow-Up Studies
  • Hepacivirus (drug effects, enzymology)
  • Hepatitis C, Chronic (drug therapy, enzymology, virology)
  • Humans
  • Interferon-alpha (therapeutic use)
  • Liver Cirrhosis (drug therapy, enzymology, virology)
  • Male
  • Middle Aged
  • Polyethylene Glycols (therapeutic use)
  • Polymerase Chain Reaction
  • Prognosis
  • RNA, Viral (genetics)
  • Recombinant Proteins (therapeutic use)
  • Retrospective Studies
  • Viral Load

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