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Journal of Thrombosis and Haemostasis

Treatment of Chronic Hepatitis C Infection in Patients with Hemophilia or Von Willebrand Disease with a Combination of Pegylated Interferon and Ribavirin

Chronic hepatitis C infection is a serious complication to treatment with plasma derived factor concentrates in patients with hemophilia and von Willebrand disease (VWD).
 In a prospective study to evaluate treatment effect of a combination of Pegylated interferon (PEG-IFN, PegIntron®, Schering-Plough) and ribavirin (Rebetol®, Schering-Plough), 90 patients (aged 16–70 years) with hemophilia or VWD, and measurable HCV-RNA in blood were included from all three Swedish hemophilia centres. Non-responders to earlier treatment with the combination, and HIV positive patients were excluded.
Twenty-two patients were scheduled for 6 months treatment and 68 patients for 12 months treatment according to study criteria. PEG-IFN (1.5 microgram/kg) was given s.c. once a week, and ribavirin (1000 mg) p.o. daily. Treatment was stopped prematurely in 20 patients (reasons: 10 non-responders after 3–6 months treatment, 9 side effects and 1 poor compliance).
So far we have HCV-data from 88 patients from end-of-treatment, and from 81 patients 6 months thereafter.
End-of-treatment response (= negative HCV-RNA) was 76% (68/90 patients) and sustained response (= negative HCV-RNA 6 months after end-of-treatment) 59% (53/90 patients). Hitherto sustained response has been seen in 27/51 patients (53%) with HCV genotype 1, 17/19 (90%) with genotype 2, 6/8 (75%) with genotype 3, 1/1 with genotype 4 and in 2/2 patients with unclassified genotype.
In conclusion, preliminary data show that treatment with PEG-IFN and ribavirin was successful in 59% of patients. As expected, treatment response was affected by the HCV genotype. Compared to our earlier experience of hepatitis C treatment, the use of PEG-IFN instead of standard IFN improved treatment response markedly.

tags:Journal of Thrombosis and Haemostasis,treatment with PEG-IFN and ribavirin,Chronic hepatitis C infection,Pegylated interferon and ribavirin,

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