Peginterferon alfa-2a plus ribavirin for hemophilic patients with chronic hepatitis C virus infection in Taiwan

Jung-An Lin, Yeu-Chin Chen, Shin-Nan Cheng, Peng-Jen Chen, Heng-Cheng Chu, Tsai-Yuan Hsieh, Yu-Lueng Shih

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background/purpose: Chronic hepatitis C virus (HCV) infection is a major cause of morbidity and mortality in patients with hemophilia. However, the efficacy and safety of pegylated interferon (PEG-IFN) plus ribavirin (RBV) for hemophilic patients with chronic HCV infection in Taiwan are still unknown. The aim of this study is to report the efficacy and safety of PEG-IFN plus RBV in a single center in Taiwan. Methods: In an open-label single-treatment one-arm cohort study, 12 hemophilic patients with elevated alanine aminotransferase level more than two times the upper limit of normal for more than 3 months received 180μg/week of PEG-IFN-α-2a plus RBV 1000-1200mg/day at a cut-off value of 75kg. The duration of treatment was 48 weeks for patients with HCV Genotype 1/4 infection and 24 weeks for patients with HCV Genotype 2/3 infection. Efficacy of therapy was expressed as sustained virological response (SVR). Results: Eight patients achieved SVR (66.7%). The SVR rates were 57%, 100%, 100%, and 0% for patients with HCV Genotypes 1, 2, 3, and 4 infection, respectively. Adverse events (AEs) developed in 10 patients (83.3%). Severe thrombocytopenia developed in one patient. However, the patient did not suffer from severe bleeding. Conclusion: Our study shows that the SVR rates are similar in hemophilic and nonhemophilic patients with chronic HCV infection who receive PEG-IFN-α-2a plus RBV in Taiwan. The rate of AEs also resembled other studies in nonhemophilic patients in Taiwan. No patient suffered from severe bleeding. However, large-scale, well-conducted studies are still needed to verify the treatment efficacy and safety. © 2013.
Original languageEnglish
Pages (from-to)727-733
Number of pages7
JournalJournal of the Formosan Medical Association
Volume113
Issue number10
DOIs
Publication statusPublished - 2014
Externally publishedYes

Fingerprint

Ribavirin
Chronic Hepatitis C
Virus Diseases
Taiwan
Hepacivirus
Interferons
Genotype
Safety
peginterferon alfa-2a
Infection
Hemorrhage
Hemophilia A
Alanine Transaminase
Thrombocytopenia
Cohort Studies
Therapeutics

Keywords

  • Hemophilia
  • Hepatitis C
  • Pegylated interferon
  • Ribavirin
  • Viral response
  • alanine aminotransferase
  • bilirubin
  • creatinine
  • peginterferon alpha2a
  • ribavirin
  • serum albumin
  • alpha interferon
  • antivirus agent
  • macrogol derivative
  • recombinant protein
  • adult
  • alanine aminotransferase blood level
  • anemia
  • Article
  • bleeding
  • chronic hepatitis
  • clinical article
  • clinical trial
  • cohort analysis
  • coughing
  • decompensated liver cirrhosis
  • drug dose reduction
  • drug efficacy
  • drug induced headache
  • drug safety
  • drug withdrawal
  • fatigue
  • female
  • flu like syndrome
  • follow up
  • hemophilia
  • hepatitis C
  • Hepatitis C virus genotype 1
  • Hepatitis C virus genotype 2
  • Hepatitis C virus genotype 3
  • Hepatitis C virus genotype 4
  • human
  • human tissue
  • insomnia
  • liver cell carcinoma
  • lung tuberculosis
  • major depression
  • male
  • middle aged
  • myalgia
  • neutropenia
  • prospective study
  • pruritus
  • sepsis
  • sustained virological response
  • Taiwan
  • thrombocytopenia
  • treatment duration
  • treatment response
  • blood
  • complication
  • drug combination
  • drug effects
  • genetics
  • genotype
  • hemophilia A
  • Hepacivirus
  • Hepatitis C, Chronic
  • procedures
  • treatment outcome
  • virology
  • virus load
  • Adult
  • Alanine Transaminase
  • Antiviral Agents
  • Cohort Studies
  • Drug Therapy, Combination
  • Genotype
  • Hemophilia A
  • Humans
  • Interferon-alpha
  • Male
  • Middle Aged
  • Polyethylene Glycols
  • Recombinant Proteins
  • Treatment Outcome
  • Viral Load

Cite this

Peginterferon alfa-2a plus ribavirin for hemophilic patients with chronic hepatitis C virus infection in Taiwan. / Lin, Jung-An; Chen, Yeu-Chin; Cheng, Shin-Nan; Chen, Peng-Jen; Chu, Heng-Cheng; Hsieh, Tsai-Yuan; Shih, Yu-Lueng.

In: Journal of the Formosan Medical Association, Vol. 113, No. 10, 2014, p. 727-733.

Research output: Contribution to journalArticle

Lin, Jung-An ; Chen, Yeu-Chin ; Cheng, Shin-Nan ; Chen, Peng-Jen ; Chu, Heng-Cheng ; Hsieh, Tsai-Yuan ; Shih, Yu-Lueng. / Peginterferon alfa-2a plus ribavirin for hemophilic patients with chronic hepatitis C virus infection in Taiwan. In: Journal of the Formosan Medical Association. 2014 ; Vol. 113, No. 10. pp. 727-733.
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title = "Peginterferon alfa-2a plus ribavirin for hemophilic patients with chronic hepatitis C virus infection in Taiwan",
abstract = "Background/purpose: Chronic hepatitis C virus (HCV) infection is a major cause of morbidity and mortality in patients with hemophilia. However, the efficacy and safety of pegylated interferon (PEG-IFN) plus ribavirin (RBV) for hemophilic patients with chronic HCV infection in Taiwan are still unknown. The aim of this study is to report the efficacy and safety of PEG-IFN plus RBV in a single center in Taiwan. Methods: In an open-label single-treatment one-arm cohort study, 12 hemophilic patients with elevated alanine aminotransferase level more than two times the upper limit of normal for more than 3 months received 180μg/week of PEG-IFN-α-2a plus RBV 1000-1200mg/day at a cut-off value of 75kg. The duration of treatment was 48 weeks for patients with HCV Genotype 1/4 infection and 24 weeks for patients with HCV Genotype 2/3 infection. Efficacy of therapy was expressed as sustained virological response (SVR). Results: Eight patients achieved SVR (66.7{\%}). The SVR rates were 57{\%}, 100{\%}, 100{\%}, and 0{\%} for patients with HCV Genotypes 1, 2, 3, and 4 infection, respectively. Adverse events (AEs) developed in 10 patients (83.3{\%}). Severe thrombocytopenia developed in one patient. However, the patient did not suffer from severe bleeding. Conclusion: Our study shows that the SVR rates are similar in hemophilic and nonhemophilic patients with chronic HCV infection who receive PEG-IFN-α-2a plus RBV in Taiwan. The rate of AEs also resembled other studies in nonhemophilic patients in Taiwan. No patient suffered from severe bleeding. However, large-scale, well-conducted studies are still needed to verify the treatment efficacy and safety. {\circledC} 2013.",
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author = "Jung-An Lin and Yeu-Chin Chen and Shin-Nan Cheng and Peng-Jen Chen and Heng-Cheng Chu and Tsai-Yuan Hsieh and Yu-Lueng Shih",
note = "被引用次數:3 Export Date: 22 March 2016 CODEN: JFASE 通訊地址: Shih, Y.-L.; Division of Gastroenterology, Tri-Service General Hospital, Number 325, Section 2, Chenggong Road, Taiwan 化學物質/CAS: alanine aminotransferase, 9000-86-6, 9014-30-6; bilirubin, 18422-02-1, 635-65-4; creatinine, 19230-81-0, 60-27-5; peginterferon alpha2a, 198153-51-4; ribavirin, 36791-04-5; serum albumin, 9048-46-8; Alanine Transaminase; Antiviral Agents; Interferon-alpha; peginterferon alfa-2a; Polyethylene Glycols; Recombinant Proteins; Ribavirin 商標: pegasys, Hoffmann La Roche, Switzerland; rebetol, Schering, United States 參考文獻: Yee, T., Griffioen, A., Sabin, C.A., Dusheiko, G., Lee, C., The natural history of HCV in a cohort of haemophilic patients infected between 1961 and 1985 (2000) Gut, 47, pp. 845-851; Rumi, M.G., Colombo, M., Gringeri, A., Mannucci, P.M., High prevalence of antibody to hepatitis C virus in multitransfused hemophiliacs with normal transaminase levels (1990) Ann Intern Med, 112, pp. 379-380; Chen, D.S., Kuo, G.C., Sung, J.L., Lai, M.Y., Sheu, J.C., Chen, P.J., Hepatitis C virus infection in an area hyperendemic for hepatitis B and chronic liver disease: the Taiwan experience (1990) J Infect Dis, 162, pp. 817-822; Franchini, M., Hepatitis C in haemophiliacs (2004) Thromb Haemost, 92, pp. 1259-1268; Lee, C., Dusheiko, G., The natural history and antiviral treatment of hepatitis C in haemophilia (2002) Haemophilia, 8, pp. 322-329; Heathcote, E.J., Shiffman, M.L., Cooksley, W.G., Dusheiko, G.M., Lee, S.S., Peginterferon alfa-2a in patients with chronic hepatitis C and cirrhosis (2000) N Engl J Med, 343, pp. 1673-1680; Manns, M.P., McHutchison, J.G., Gordon, S.C., Rustgi, V.K., Shiffman, M., Reindollar, R., Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial (2001) Lancet, 358, pp. 958-965; Zeuzem, S., Feinman, S.V., Rasenack, J., Heathcote, E.J., Lai, M.Y., Gane, E., Peginterferon alfa-2a in patients with chronic hepatitis C (2000) N Engl J Med, 343, pp. 1666-1672; Franchini, M., Mengoli, C., Veneri, D., Mazzi, R., Lippi, G., Cruciani, M., Treatment of chronic hepatitis C in haemophilic patients with interferon and ribavirin: a meta-analysis (2008) J Antimicrob Chemother, 61, pp. 1191-1200; Lee, S.D., Chan, C.Y., Wang, Y.J., Wu, J.C., Lai, K.H., Tsai, Y.T., Seroepidemiology of hepatitis C virus infection in Taiwan (1991) Hepatology, 13, pp. 830-833; Seeff, L.B., Hollinger, F.B., Alter, H.J., Wright, E.C., Cain, C.M., Buskell, Z.J., Long-term mortality and morbidity of transfusion-associated non-A, non-B, and type C hepatitis: a National Heart, Lung, and Blood Institute collaborative study (2001) Hepatology, 33, pp. 455-463; Zhang, M., Rosenberg, P.S., Brown, D.L., Preiss, L., Konkle, B.A., Eyster, M.E., Correlates of spontaneous clearance of hepatitis C virus among people with hemophilia (2006) Blood, 107, pp. 892-897; Liu, C.J., Chuang, W.L., Lee, C.M., Yu, M.L., Lu, S.N., Wu, S.S., Peginterferon alfa-2a plus ribavirin for the treatment of dual chronic infection with hepatitis B and C viruses (2009) Gastroenterology, 136, pp. 496-504. , e3; Liu, C.H., Liu, C.J., Lin, C.L., Liang, C.C., Hsu, S.J., Yang, S.S., Pegylated interferon-alpha-2a plus ribavirin for treatment-naive Asian patients with hepatitis C virus genotype 1 infection: a multicenter, randomized controlled trial (2008) Clin Infect Dis, 47, pp. 1260-1269; Yu, M.L., Dai, C.Y., Huang, J.F., Chiu, C.F., Yang, Y.H., Hou, N.J., Rapid virological response and treatment duration for chronic hepatitis C genotype 1 patients: a randomized trial (2008) Hepatology, 47, pp. 1884-1893; Yu, M.L., Dai, C.Y., Lin, Z.Y., Lee, L.P., Hou, N.J., Hsieh, M.Y., A randomized trial of 24- vs. 48-week courses of PEG interferon alpha-2b plus ribavirin for genotype-1b-infected chronic hepatitis C patients: a pilot study in Taiwan (2006) Liver Int, 26, pp. 73-81; Chuang, W.L., Yu, M.L., Dai, C.Y., Chang, W.Y., Treatment of chronic hepatitis C in southern Taiwan (2006) Intervirology, 49, pp. 99-106; Yu, M.L., Dai, C.Y., Huang, J.F., Hou, N.J., Lee, L.P., Hsieh, M.Y., A randomised study of peginterferon and ribavirin for 16 versus 24 weeks in patients with genotype 2 chronic hepatitis C (2007) Gut, 56, pp. 553-559; Yu, M.L., Chuang, W.L., Treatment of chronic hepatitis C in Asia: when East meets West (2009) J Gastroenterol Hepatol, 24, pp. 336-345; Huang, C.F., Huang, J.F., Yang, J.F., Hsieh, M.Y., Lin, Z.Y., Chen, S.C., Interleukin-28B genetic variants in identification of hepatitis C virus genotype 1 patients responding to 24 weeks peginterferon/ribavirin (2012) J Hepatol, 56, pp. 34-40; Liu, C.H., Liang, C.C., Liu, C.J., Tseng, T.C., Lin, C.L., Yang, S.S., Interleukin 28B genetic polymorphisms and viral factors help identify HCV genotype-1 patients who benefit from 24-week pegylated interferon plus ribavirin therapy (2012) Antivir Ther, 17, pp. 477-484; Ge, D., Fellay, J., Thompson, A.J., Simon, J.S., Shianna, K.V., Urban, T.J., Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance (2009) Nature, 461, pp. 399-401; Witkos, M., Yi, Q.L., Heathcote, J., Kapral, M.K., Krahn, M.D., Predictors of antiviral therapy in a post-transfusion cohort of hepatitis C patients (2006) Can J Gastroenterol, 20, pp. 107-111; Posthouwer, D., Plug, I., van der Bom, J.G., Fischer, K., Rosendaal, F.R., Mauser-Bunschoten, E.P., Hepatitis C infection among Dutch haemophilia patients: a nationwide cross-sectional study of prevalence and antiviral treatment (2005) Haemophilia, 11, pp. 270-275; Kevans, D., Farrell, G., Hopkins, S., Mahmud, N., White, B., Norris, S., Haematological support during peg-interferon therapy for HCV-infected haemophiliacs improves virological outcomes (2007) Haemophilia, 13, pp. 593-598; Pockros, P.J., Shiffman, M.L., Schiff, E.R., Sulkowski, M.S., Younossi, Z., Dieterich, D.T., Epoetin alfa improves quality of life in anemic HCV-infected patients receiving combination therapy (2004) Hepatology, 40, pp. 1450-1458; Koirala, J., Gandotra, S.D., Rao, S., Sangwan, G., Mushtaq, A., Htwe, T.H., Granulocyte colony-stimulating factor dosing in pegylated interferon alpha-induced neutropenia and its impact on outcome of anti-HCV therapy (2007) J Viral Hepat, 14, pp. 782-787; Collantes, R.S., Younossi, Z.M., The use of growth factors to manage the hematologic side effects of PEG-interferon alfa and ribavirin (2005) J Clin Gastroenterol, 39, pp. S9-S13; Shiffman, M.L., Salvatore, J., Hubbard, S., Price, A., Sterling, R.K., Stravitz, R.T., Treatment of chronic hepatitis C virus genotype 1 with peginterferon, ribavirin, and epoetin alpha (2007) Hepatology, 46, pp. 371-379; Afdhal, N.H., Dieterich, D.T., Pockros, P.J., Schiff, E.R., Shiffman, M.L., Sulkowski, M.S., Epoetin alfa maintains ribavirin dose in HCV-infected patients: a prospective, double-blind, randomized controlled study (2004) Gastroenterology, 126, pp. 1302-1311; Alavian, S.M., Tabatabaei, S.V., Keshvari, M., Behnava, B., Miri, S.M., Elizee, P.K., Peginterferon alpha-2a and ribavirin treatment of patients with haemophilia and hepatitis C virus infection: a single-centre study of 367 cases (2010) Liver Int, 30, pp. 1173-1180; Yang, J.F., Kao, Y.H., Dai, C.Y., Huang, J.F., Hsieh, M.Y., Lin, Z.Y., Comparison of adverse effects related to pegylated interferon-based therapy for patients with chronic hepatitis B and chronic hepatitis C in Taiwan (2010) Hepatol Int, 4, pp. 732-740",
year = "2014",
doi = "10.1016/j.jfma.2013.10.010",
language = "English",
volume = "113",
pages = "727--733",
journal = "Journal of the Formosan Medical Association",
issn = "0929-6646",
publisher = "Elsevier Science Publishers B.V.",
number = "10",

}

TY - JOUR

T1 - Peginterferon alfa-2a plus ribavirin for hemophilic patients with chronic hepatitis C virus infection in Taiwan

AU - Lin, Jung-An

AU - Chen, Yeu-Chin

AU - Cheng, Shin-Nan

AU - Chen, Peng-Jen

AU - Chu, Heng-Cheng

AU - Hsieh, Tsai-Yuan

AU - Shih, Yu-Lueng

N1 - 被引用次數:3 Export Date: 22 March 2016 CODEN: JFASE 通訊地址: Shih, Y.-L.; Division of Gastroenterology, Tri-Service General Hospital, Number 325, Section 2, Chenggong Road, Taiwan 化學物質/CAS: alanine aminotransferase, 9000-86-6, 9014-30-6; bilirubin, 18422-02-1, 635-65-4; creatinine, 19230-81-0, 60-27-5; peginterferon alpha2a, 198153-51-4; ribavirin, 36791-04-5; serum albumin, 9048-46-8; Alanine Transaminase; Antiviral Agents; Interferon-alpha; peginterferon alfa-2a; Polyethylene Glycols; Recombinant Proteins; Ribavirin 商標: pegasys, Hoffmann La Roche, Switzerland; rebetol, Schering, United States 參考文獻: Yee, T., Griffioen, A., Sabin, C.A., Dusheiko, G., Lee, C., The natural history of HCV in a cohort of haemophilic patients infected between 1961 and 1985 (2000) Gut, 47, pp. 845-851; Rumi, M.G., Colombo, M., Gringeri, A., Mannucci, P.M., High prevalence of antibody to hepatitis C virus in multitransfused hemophiliacs with normal transaminase levels (1990) Ann Intern Med, 112, pp. 379-380; Chen, D.S., Kuo, G.C., Sung, J.L., Lai, M.Y., Sheu, J.C., Chen, P.J., Hepatitis C virus infection in an area hyperendemic for hepatitis B and chronic liver disease: the Taiwan experience (1990) J Infect Dis, 162, pp. 817-822; Franchini, M., Hepatitis C in haemophiliacs (2004) Thromb Haemost, 92, pp. 1259-1268; Lee, C., Dusheiko, G., The natural history and antiviral treatment of hepatitis C in haemophilia (2002) Haemophilia, 8, pp. 322-329; Heathcote, E.J., Shiffman, M.L., Cooksley, W.G., Dusheiko, G.M., Lee, S.S., Peginterferon alfa-2a in patients with chronic hepatitis C and cirrhosis (2000) N Engl J Med, 343, pp. 1673-1680; Manns, M.P., McHutchison, J.G., Gordon, S.C., Rustgi, V.K., Shiffman, M., Reindollar, R., Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial (2001) Lancet, 358, pp. 958-965; Zeuzem, S., Feinman, S.V., Rasenack, J., Heathcote, E.J., Lai, M.Y., Gane, E., Peginterferon alfa-2a in patients with chronic hepatitis C (2000) N Engl J Med, 343, pp. 1666-1672; Franchini, M., Mengoli, C., Veneri, D., Mazzi, R., Lippi, G., Cruciani, M., Treatment of chronic hepatitis C in haemophilic patients with interferon and ribavirin: a meta-analysis (2008) J Antimicrob Chemother, 61, pp. 1191-1200; Lee, S.D., Chan, C.Y., Wang, Y.J., Wu, J.C., Lai, K.H., Tsai, Y.T., Seroepidemiology of hepatitis C virus infection in Taiwan (1991) Hepatology, 13, pp. 830-833; Seeff, L.B., Hollinger, F.B., Alter, H.J., Wright, E.C., Cain, C.M., Buskell, Z.J., Long-term mortality and morbidity of transfusion-associated non-A, non-B, and type C hepatitis: a National Heart, Lung, and Blood Institute collaborative study (2001) Hepatology, 33, pp. 455-463; Zhang, M., Rosenberg, P.S., Brown, D.L., Preiss, L., Konkle, B.A., Eyster, M.E., Correlates of spontaneous clearance of hepatitis C virus among people with hemophilia (2006) Blood, 107, pp. 892-897; Liu, C.J., Chuang, W.L., Lee, C.M., Yu, M.L., Lu, S.N., Wu, S.S., Peginterferon alfa-2a plus ribavirin for the treatment of dual chronic infection with hepatitis B and C viruses (2009) Gastroenterology, 136, pp. 496-504. , e3; Liu, C.H., Liu, C.J., Lin, C.L., Liang, C.C., Hsu, S.J., Yang, S.S., Pegylated interferon-alpha-2a plus ribavirin for treatment-naive Asian patients with hepatitis C virus genotype 1 infection: a multicenter, randomized controlled trial (2008) Clin Infect Dis, 47, pp. 1260-1269; Yu, M.L., Dai, C.Y., Huang, J.F., Chiu, C.F., Yang, Y.H., Hou, N.J., Rapid virological response and treatment duration for chronic hepatitis C genotype 1 patients: a randomized trial (2008) Hepatology, 47, pp. 1884-1893; Yu, M.L., Dai, C.Y., Lin, Z.Y., Lee, L.P., Hou, N.J., Hsieh, M.Y., A randomized trial of 24- vs. 48-week courses of PEG interferon alpha-2b plus ribavirin for genotype-1b-infected chronic hepatitis C patients: a pilot study in Taiwan (2006) Liver Int, 26, pp. 73-81; Chuang, W.L., Yu, M.L., Dai, C.Y., Chang, W.Y., Treatment of chronic hepatitis C in southern Taiwan (2006) Intervirology, 49, pp. 99-106; Yu, M.L., Dai, C.Y., Huang, J.F., Hou, N.J., Lee, L.P., Hsieh, M.Y., A randomised study of peginterferon and ribavirin for 16 versus 24 weeks in patients with genotype 2 chronic hepatitis C (2007) Gut, 56, pp. 553-559; Yu, M.L., Chuang, W.L., Treatment of chronic hepatitis C in Asia: when East meets West (2009) J Gastroenterol Hepatol, 24, pp. 336-345; Huang, C.F., Huang, J.F., Yang, J.F., Hsieh, M.Y., Lin, Z.Y., Chen, S.C., Interleukin-28B genetic variants in identification of hepatitis C virus genotype 1 patients responding to 24 weeks peginterferon/ribavirin (2012) J Hepatol, 56, pp. 34-40; Liu, C.H., Liang, C.C., Liu, C.J., Tseng, T.C., Lin, C.L., Yang, S.S., Interleukin 28B genetic polymorphisms and viral factors help identify HCV genotype-1 patients who benefit from 24-week pegylated interferon plus ribavirin therapy (2012) Antivir Ther, 17, pp. 477-484; Ge, D., Fellay, J., Thompson, A.J., Simon, J.S., Shianna, K.V., Urban, T.J., Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance (2009) Nature, 461, pp. 399-401; Witkos, M., Yi, Q.L., Heathcote, J., Kapral, M.K., Krahn, M.D., Predictors of antiviral therapy in a post-transfusion cohort of hepatitis C patients (2006) Can J Gastroenterol, 20, pp. 107-111; Posthouwer, D., Plug, I., van der Bom, J.G., Fischer, K., Rosendaal, F.R., Mauser-Bunschoten, E.P., Hepatitis C infection among Dutch haemophilia patients: a nationwide cross-sectional study of prevalence and antiviral treatment (2005) Haemophilia, 11, pp. 270-275; Kevans, D., Farrell, G., Hopkins, S., Mahmud, N., White, B., Norris, S., Haematological support during peg-interferon therapy for HCV-infected haemophiliacs improves virological outcomes (2007) Haemophilia, 13, pp. 593-598; Pockros, P.J., Shiffman, M.L., Schiff, E.R., Sulkowski, M.S., Younossi, Z., Dieterich, D.T., Epoetin alfa improves quality of life in anemic HCV-infected patients receiving combination therapy (2004) Hepatology, 40, pp. 1450-1458; Koirala, J., Gandotra, S.D., Rao, S., Sangwan, G., Mushtaq, A., Htwe, T.H., Granulocyte colony-stimulating factor dosing in pegylated interferon alpha-induced neutropenia and its impact on outcome of anti-HCV therapy (2007) J Viral Hepat, 14, pp. 782-787; Collantes, R.S., Younossi, Z.M., The use of growth factors to manage the hematologic side effects of PEG-interferon alfa and ribavirin (2005) J Clin Gastroenterol, 39, pp. S9-S13; Shiffman, M.L., Salvatore, J., Hubbard, S., Price, A., Sterling, R.K., Stravitz, R.T., Treatment of chronic hepatitis C virus genotype 1 with peginterferon, ribavirin, and epoetin alpha (2007) Hepatology, 46, pp. 371-379; Afdhal, N.H., Dieterich, D.T., Pockros, P.J., Schiff, E.R., Shiffman, M.L., Sulkowski, M.S., Epoetin alfa maintains ribavirin dose in HCV-infected patients: a prospective, double-blind, randomized controlled study (2004) Gastroenterology, 126, pp. 1302-1311; Alavian, S.M., Tabatabaei, S.V., Keshvari, M., Behnava, B., Miri, S.M., Elizee, P.K., Peginterferon alpha-2a and ribavirin treatment of patients with haemophilia and hepatitis C virus infection: a single-centre study of 367 cases (2010) Liver Int, 30, pp. 1173-1180; Yang, J.F., Kao, Y.H., Dai, C.Y., Huang, J.F., Hsieh, M.Y., Lin, Z.Y., Comparison of adverse effects related to pegylated interferon-based therapy for patients with chronic hepatitis B and chronic hepatitis C in Taiwan (2010) Hepatol Int, 4, pp. 732-740

PY - 2014

Y1 - 2014

N2 - Background/purpose: Chronic hepatitis C virus (HCV) infection is a major cause of morbidity and mortality in patients with hemophilia. However, the efficacy and safety of pegylated interferon (PEG-IFN) plus ribavirin (RBV) for hemophilic patients with chronic HCV infection in Taiwan are still unknown. The aim of this study is to report the efficacy and safety of PEG-IFN plus RBV in a single center in Taiwan. Methods: In an open-label single-treatment one-arm cohort study, 12 hemophilic patients with elevated alanine aminotransferase level more than two times the upper limit of normal for more than 3 months received 180μg/week of PEG-IFN-α-2a plus RBV 1000-1200mg/day at a cut-off value of 75kg. The duration of treatment was 48 weeks for patients with HCV Genotype 1/4 infection and 24 weeks for patients with HCV Genotype 2/3 infection. Efficacy of therapy was expressed as sustained virological response (SVR). Results: Eight patients achieved SVR (66.7%). The SVR rates were 57%, 100%, 100%, and 0% for patients with HCV Genotypes 1, 2, 3, and 4 infection, respectively. Adverse events (AEs) developed in 10 patients (83.3%). Severe thrombocytopenia developed in one patient. However, the patient did not suffer from severe bleeding. Conclusion: Our study shows that the SVR rates are similar in hemophilic and nonhemophilic patients with chronic HCV infection who receive PEG-IFN-α-2a plus RBV in Taiwan. The rate of AEs also resembled other studies in nonhemophilic patients in Taiwan. No patient suffered from severe bleeding. However, large-scale, well-conducted studies are still needed to verify the treatment efficacy and safety. © 2013.

AB - Background/purpose: Chronic hepatitis C virus (HCV) infection is a major cause of morbidity and mortality in patients with hemophilia. However, the efficacy and safety of pegylated interferon (PEG-IFN) plus ribavirin (RBV) for hemophilic patients with chronic HCV infection in Taiwan are still unknown. The aim of this study is to report the efficacy and safety of PEG-IFN plus RBV in a single center in Taiwan. Methods: In an open-label single-treatment one-arm cohort study, 12 hemophilic patients with elevated alanine aminotransferase level more than two times the upper limit of normal for more than 3 months received 180μg/week of PEG-IFN-α-2a plus RBV 1000-1200mg/day at a cut-off value of 75kg. The duration of treatment was 48 weeks for patients with HCV Genotype 1/4 infection and 24 weeks for patients with HCV Genotype 2/3 infection. Efficacy of therapy was expressed as sustained virological response (SVR). Results: Eight patients achieved SVR (66.7%). The SVR rates were 57%, 100%, 100%, and 0% for patients with HCV Genotypes 1, 2, 3, and 4 infection, respectively. Adverse events (AEs) developed in 10 patients (83.3%). Severe thrombocytopenia developed in one patient. However, the patient did not suffer from severe bleeding. Conclusion: Our study shows that the SVR rates are similar in hemophilic and nonhemophilic patients with chronic HCV infection who receive PEG-IFN-α-2a plus RBV in Taiwan. The rate of AEs also resembled other studies in nonhemophilic patients in Taiwan. No patient suffered from severe bleeding. However, large-scale, well-conducted studies are still needed to verify the treatment efficacy and safety. © 2013.

KW - Hemophilia

KW - Hepatitis C

KW - Pegylated interferon

KW - Ribavirin

KW - Viral response

KW - alanine aminotransferase

KW - bilirubin

KW - creatinine

KW - peginterferon alpha2a

KW - ribavirin

KW - serum albumin

KW - alpha interferon

KW - antivirus agent

KW - macrogol derivative

KW - recombinant protein

KW - adult

KW - alanine aminotransferase blood level

KW - anemia

KW - Article

KW - bleeding

KW - chronic hepatitis

KW - clinical article

KW - clinical trial

KW - cohort analysis

KW - coughing

KW - decompensated liver cirrhosis

KW - drug dose reduction

KW - drug efficacy

KW - drug induced headache

KW - drug safety

KW - drug withdrawal

KW - fatigue

KW - female

KW - flu like syndrome

KW - follow up

KW - hemophilia

KW - hepatitis C

KW - Hepatitis C virus genotype 1

KW - Hepatitis C virus genotype 2

KW - Hepatitis C virus genotype 3

KW - Hepatitis C virus genotype 4

KW - human

KW - human tissue

KW - insomnia

KW - liver cell carcinoma

KW - lung tuberculosis

KW - major depression

KW - male

KW - middle aged

KW - myalgia

KW - neutropenia

KW - prospective study

KW - pruritus

KW - sepsis

KW - sustained virological response

KW - Taiwan

KW - thrombocytopenia

KW - treatment duration

KW - treatment response

KW - blood

KW - complication

KW - drug combination

KW - drug effects

KW - genetics

KW - genotype

KW - hemophilia A

KW - Hepacivirus

KW - Hepatitis C, Chronic

KW - procedures

KW - treatment outcome

KW - virology

KW - virus load

KW - Adult

KW - Alanine Transaminase

KW - Antiviral Agents

KW - Cohort Studies

KW - Drug Therapy, Combination

KW - Genotype

KW - Hemophilia A

KW - Humans

KW - Interferon-alpha

KW - Male

KW - Middle Aged

KW - Polyethylene Glycols

KW - Recombinant Proteins

KW - Treatment Outcome

KW - Viral Load

U2 - 10.1016/j.jfma.2013.10.010

DO - 10.1016/j.jfma.2013.10.010

M3 - Article

VL - 113

SP - 727

EP - 733

JO - Journal of the Formosan Medical Association

JF - Journal of the Formosan Medical Association

SN - 0929-6646

IS - 10

ER -