Peg-interferon alone or combined with ribavirin in HCV cirrhosis with portal hyp

August 22, 2007

J Hepatol. 2007 Jun 27; [Epub ahead of print]

Peg-interferon alone or combined with ribavirin in HCV cirrhosis with portal

hypertension: A randomized controlled trial.

Di Marco V, Almasio PL, Ferraro D, Calvaruso V, Alaimo G, Peralta S, Di

Stefano R, Craxì A.

Cattedra di Gastroenterologia and Unità Operativa Complessa di

Gastroenterologia ed Epatologia, Di.Bi.M.I.S, Piazza delle Cliniche 2, 90127

Palermo, Italy.

BACKGROUND/AIMS: Risks and benefits of antiviral therapy in HCV cirrhosis

with portal hypertension are poorly known. METHODS: We performed a

randomized controlled trial in 102 HCV patients with compensated cirrhosis

and portal hypertension: 51 received 1mug/kg/week of Pegylated-interferon

alpha-2b and 51 Pegylated-interferon plus 800mg/day of ribavirin up to 52

weeks. RESULTS: By intention-to-treat analysis, five patients on monotherapy

and eleven on combination therapy achieved a sustained virological response

(9.8% vs. 21.6%, p=0.06). The response was more frequent for genotypes 2 or

3 than genotype 1 (66.6% vs. 11.3%, p=0.001). Genotype 1, who had low viral

load at start of therapy, were HCV-RNA negative at 4 weeks, and were

adherent to the scheduled therapy had a higher probability of sustained

virological response. Patients with sustained virological response had less

disease events compared to nonresponders (6.2% vs. 38.3%, p=0.03 by log rank

test) during follow-up. CONCLUSIONS: In HCV cirrhosis with portal

hypertension Peg-interferon plus ribavirin is a feasible treatment. Although

the rate of viral eradication is modest, tailoring by genotype and early

viral response allows to keep patients on treatment who are more likely to

have viral eradication. Patients with viral eradication have fewer disease

complications during follow-up.

PMID: 17692985 [PubMed - as supplied by publisher]

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