Abstract | BACKGROUND/AIMS: This study aims to evaluate the efficacy and tolerability of low-dose PEGylated interferon (PEG-IFN) a-2a combined with standard of care ribavirin (RBV). The therapy was administered to patients with chronic hepatitis C virus (HCV) with decompensated cirrhosis who underwent splenectomy or partial splenic artery embolization. METHODOLOGY: A total of 106 patients with decompensated liver cirrhosis with chronic HCV infection were subjected to splenectomy (n = 89) or partial spleen artery embolization (n = 17) without the possibility of starting or continuing PEG-IFN and RBV because of neutropenia and/or thrombocytopenia. Antiviral treatment was started when the neutrocyte and platelet counts were increased and without severe surgical complications. A sustained virological response was obtained in 38 genotype 1 patients (59.3%) and 14 non-genotype 1 patients (56%) who underwent splenectomy and 6 genotype 1 patients (46.15%) and 3 non-genotype 1 patients (75%) who underwent partial splenic embolization. In the splenectomy group, the non-response rate of the genotype 1 patients was 28.13%, whereas that for non-genotype 1 patients was 24%. RESULTS: In the PSE group, the non-response rate among genotype 1 patients was 23.08%. All patients in the non-genotype 1 group obtained virological responses. The side effect was neutropenia. No patient died while on therapy. CONCLUSIONS: Both splenectomy and partial spleen artery embolization could be beneficial for low-dose PEG-IFNa-2a plus RBV antiviral therapy for early decompensated liver cirrhosis patients with chronic HCV infection and would not influence antiviral efficacy. However, patients should undergo complete follow-up.
|
Authors | Ying Sun, Binxia Chang, Guangju Teng, Wei Zhang, Jun Zhao, Baosen Li |
Journal | Hepato-gastroenterology
(Hepatogastroenterology)
Vol. 60
Issue 126
Pg. 1391-8
(Sep 2013)
ISSN: 0172-6390 [Print] Greece |
PMID | 23635509
(Publication Type: Journal Article)
|
Chemical References |
- Antiviral Agents
- Interferon-alpha
- Recombinant Proteins
- Polyethylene Glycols
- Ribavirin
- peginterferon alfa-2a
|
Topics |
- Adult
- Aged
- Antiviral Agents
(administration & dosage)
- Drug Therapy, Combination
- Embolization, Therapeutic
- Female
- Hepatitis C, Chronic
(complications, drug therapy)
- Humans
- Interferon-alpha
(administration & dosage, adverse effects)
- Liver Cirrhosis
(etiology, therapy)
- Male
- Middle Aged
- Polyethylene Glycols
(administration & dosage, adverse effects)
- Recombinant Proteins
(administration & dosage, adverse effects)
- Ribavirin
(administration & dosage, adverse effects)
- Splenectomy
|