Remission of manic disorder in a hepatitis c virus (HCV) infected patient receiving pegylated-interferon (PEGIFN) plus ribavirin (RBV)

2011 ◽  
Vol 26 (S2) ◽  
pp. 881-881
Author(s):  
C.L. Ortiz Sánchez-Expósito ◽  
M. Machín Vazquez-Illá ◽  
L. Gallego Deike ◽  
J.J. López-Ibor
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Infected Patient ◽  
Psychotic Disorders ◽  
Neuropsychiatric Symptoms ◽  
Pegylated Interferon ◽  
Psychotic Symptoms ◽  
Hcv Rna ◽  
Antipsychotic Therapy

IntroductionPegylated-interferon (pegIFN) plus ribavirin (RBV) is for the moment the licensed therapy for chronic hepatitis C. Neuropsychiatric symptoms are frequent side effects due to the treatment with pegIFN, registered in 30 to 80% of instances, with mood rather than psychotic disorders usually observed.ObjectiveA manic profile with psychotic symptoms in a HCV infected patient receiving pegIFN-RBV is presented to discuss management strategies and outcome.MethodsA 47 year-old male patient, former IDU and alcohol abuser, without past psychiatric history, was under therapy for chronic hepatitis C (genotype 1a, HCV-RNA 6.2 log IU/mL, Child A5). After 14 weeks of pegIFN-RBV treatment the patient attends ER with insomnia, uneasiness, expansive mood, irritability, extravagant and disinhibited behaviour, and detrimental and self-referential delusion.ResultsThe patient was admitted at the Psychiatric Unit to receive amisulpride (400 mg/12h) plus lorazepam (1 mg/8h), with psychotic symptoms regressing over following days. It was agreed that psychotropic drugs would be maintained at the same doses until the end pegIFN-RBV therapy, intended for 48 weeks.ConclusionAntipsychotic therapy may be effective and allows VHC infected patients with manic symptoms related to pegIFN-RBV therapy to continue their treatment.

Discordance between HCV RNA assays for week 24 HCV RNA determination during pegylated interferon-α/ribavirin treatment for chronic hepatitis C

2011 ◽  
Vol 16 (5) ◽  
pp. 771-774
Author(s):  
Robert Roomer ◽  
Anneke J van Vuuren ◽  
Martin Schutten ◽  
Angela Heijens ◽  
Harry LA Janssen ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Pegylated Interferon ◽  
Interferon Α ◽  
Hcv Rna

scholarly journals Efficacy and safety of peginterferon alfa-2a and ribavirin treatment of chronic hepatitis C in the Republic of Serbia

2012 ◽  
Vol 140 (7-8) ◽  
pp. 448-455
Author(s):  
Milena Bozic ◽  
Ksenija Bojovic ◽  
Milotka Fabri ◽  
Darko Nozic ◽  
Bojan Trkulja ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Pegylated Interferon ◽  
Multicenter Trial ◽  
Multivariable Logistic Regression Analysis ◽  
Hcv Rna ◽  
Efficacy And Safety ◽  
Specific Pcr ◽  
Adverse Affects

Introduction. Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide. Pegylated interferon alfa-2a or 2b (PEG IFN alfa-2a or 2b) and ribavirin (RBV) represent a standard treatment of chronic hepatitis C (CHC). Sustained virological response (SVR), defined as continued undetectable HCV RNA 24 weeks after completion of treatment, is universally considered as an indicator of treatment efficacy. Objective. The aim of this study was to determine efficacy and safety of PEG IFN alfa-2a and RBV treatment in patients with CHC in Serbia. Methods. One hundred seventy-six patients with CHC were included in this multicenter trial from 8 reference centers in Serbia. The patients were treated with standard PEG IFN alfa- 2a and RBV protocol. We performed the following virological testing: anti-HCV (ELISA), HCV RNK (quantitative PCR), HCV genotype (type-specific PCR), HBsAg, anti-HBs, anti-HBc and anti-HIV (ELISA). Histological activity and the degree of fibrosis were determined according to the Metavir scoring system. Potential predictors for achieving SVR were evaluated using multivariable logistic regression analysis. Results. Of the treated patients with CHC 65.9% were male, and 60.2% of them aged over 40 years. Of the treated patients 68.2% had infection over 5 years, 63% had HCV RNA >400.000 IU/mL, 76.1% had HCV G1/4, and 60.1% had a mild to moderate liver fibrosis. SVR was achieved in 78.9% of patients (G1/4 79.1%; G2/3 78.1%). The factors that indicated a poorer efficacy of the treatment were age >40 (p<0.05), high basal viremia (p=0.013), and the reduction of PEG IFN alfa-2a and RBV doses, with interruption of therapy (p<0.001). Of the treated patients 45.9% had adverse affects (G1/4 50.8%; G2/3 29.7%). Conclusion. Treatment of CHC with PEG IFN alfa-2a and RBV was efficient in 78.9% of patients. The safety profile of therapy was satisfactory. Longer therapy increases the possibility of the development of adverse affects. No life-threatening adverse effects were recorded in our patients.

High Efficacy of Combination Therapy with Pegylated Interferon and Ribavirin in Hemophiliacs with Chronic Hepatitis C.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 3219-3219
Author(s):  
Maria E. Mancuso ◽  
Elena Santagostino ◽  
Maria G. Rumi ◽  
Silvia Linari ◽  
Antonio Coppola ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Side Effects ◽  
Combination Therapy ◽  
Chronic Hepatitis C ◽  
Univariate Analysis ◽  
Pegylated Interferon ◽  
Hcv Rna ◽  
Genotype 2

Abstract Pegylated interferon (Peg-IFN) plus ribavirin is the standard treatment for patients with chronic hepatitis C. In a multicenter open trial, we assessed the efficacy and tolerability of this treatment in 78 HIV negative hemophiliacs (age: 20–64 years) with persistently high transaminase values. Sixty-four were naïve and 14 were relapsers to IFN monotherapy. Cirrhosis was clinically detected in 12 patients (15%). HCV genotype was 1 in 69%, 2a/c in 14%, 3a in 14% and 4 in 3%. Peg-IFN alpha-2b was given subcutaneously at doses of 1.5 mcg/Kg/week for 48 weeks in genotypes 1 and 4 and for 24 weeks in genotypes 2 and 3; oral ribavirin at 800–1200 mg/day based on body weight. Treatment was stopped in patients with polymerase chain reaction positive HCV-RNA at month 6. Results: 11 patients (14%) withdrew for side effects (4) or non-compliance (7). Neutropenia (&lt;500 cells/mmc), decompensated diabetes, ALT flares, and vomiting not responding to antiemetic drugs were reasons for treatment discontinuation. The median fall in hemoglobin levels was 3.1 g/dL. Weight loss (38%), fatigue (33%) and cephalalgia (15%) were frequent side effects. Thirty-two patients (41%) required dose reduction of ribavirin (23, 29%) or Peg-IFN (20, 26%). At the end of the 6-month follow-up, sustained virological response (SVR) was achieved in 43 patients (55%): 40/64 naïve (63%) and 3/14 relapsers (21%, p = 0.007). Five patients (6%), all relapsers to IFN monotherapy, had a virological breakthrough during treatment and 4 (5%) relapsed during the post-treatment follow-up period. SVR was obtained in 86% genotypes 2/3 and 43% genotypes 1/4 (p = 0.001). Predictors of SVR were evaluated by univariate analysis in the 64 naïve patients. SVR was significantly associated with HCV infection type 2 and 3 (86% vs 50% in HCV type 1 and 4; p = 0.008), absence of cirrhosis (97.5% vs 75% in non-responders; p = 0.02) and higher pre-treatment serum ALT levels (111 vs 75 IU/L in non-responders; p = 0.02). SVR rates did not differ in relation to patient’s age, pretreatment HCV viremia, median disease duration and compliance to full-dose treatment. Conclusions: combination therapy with Peg-IFN plus ribavirin is the recommended therapeutic option for hemophiliacs with hepatitis C chronic infection. Relapsers to IFN monotherapy may benefit of re-treatment with Peg-IFN plus ribavirin achieving at least 20% SVR. Genotype 2 and 3 infection is the most significant predictor of SVR.

scholarly journals Influence of pegylated interferon and ribavirin on insulin resistance and metabolic factors in chronic hepatitis C

2018 ◽  
Vol 44 (2) ◽  
pp. 170-176
Author(s):  
Zeynep Altın ◽  
Gülden Diniz ◽  
Ayfer Çolak ◽  
Betül Koyuncu ◽  
Serhat Özer ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Serum Insulin ◽  
Pegylated Interferon ◽  
Hcv Rna ◽  
Model Assessment ◽  
Metabolic Factors ◽  
Significant Difference

Abstract Background In this study it was aimed to evaluate the effect of pegylated interferon alfa-2a/2b and ribavirin, which are used for treatment of chronic hepatitis C (CHC), on insulin resistance and metabolic factors. Materials and methods A total of 104 CHC patients aged 20–75 years with available serum insulin data at 0 and 48 weeks, and hepatitis C virus (HCV)-RNA data at 0, 12, 24, 48 and 72 weeks were included in the study. All clinical para-meters were assessed according to the therapy response. Results Among 104 patients, sustained virologic response (SVR) was achieved in 55 cases. A statistically significant difference was noted between SVR and non-SVR groups regarding γ-glutamyltranspeptidase (GGT), insulin level plus homeostasis model assessment (HOMA) score and insulin resistance at week 48, log HCV-RNA and stage of fibrosis. Conclusion Insulin resistance is accepted to have a negative effect on SVR. Insulin resistance may improve once SVR is achieved. Presence of IR at week 48 has been found associated with SVR. In this context, it can be advocated that insulin resistance at week 48 may be a predictive factor for prediction of SVR at week 72.

scholarly journals Antiviral/immunomodulatory combination therapy: Pegylated interferon alpha 2a and ribavirin in patients with chronic hepatitis C virus infection

2012 ◽  
Vol 140 (9-10) ◽  
pp. 612-618
Author(s):  
Dragan Delic ◽  
Nikola Mitrovic ◽  
Natasa Popovic ◽  
Aleksandar Urosevic ◽  
Ivana Pesic ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Combination Therapy ◽  
Chronic Hepatitis C ◽  
Interferon Alpha ◽  
Pegylated Interferon ◽  
Hcv Rna ◽  
Pegylated Interferon Alpha ◽  
Chronic Hepatitis C Virus

Introduction. Chronic hepatitis C virus (HCV) infection can progress to liver cirrhosis that causes bleeding from the gastrointestinal tract, liver failure and primary hepatocellular carcinoma. Use of standard therapeutic option consists of recombinant pegylated interferon alpha 2a/b with ribavirin in order to eradicate virus and prevent complications. Objective. The aim of investigation was to evaluate efficiency of combination therapy (pegylated interferon alpha 2a/b plus ribavirin) in patients with chronic HCV infection and to estimate predictive factors for successful treatment. Methods. A total of 387 patients with confirmed diagnosis of hepatitis C were evaluated (aged 18-65 years of both genders). Patients were treated with pegylated interferon alpha 2a/b and ribavirin according to a standard regimen lasting 24 or 48 weeks, dependent on virus genotype. Results. Negative HCV RNA (PCR assay) was recorded in 79.7% of patients at the end of treatment. Six months after completed therapy, negative HCV RNA, i.e. stained virologic response (SVR) was assessed in 70.5% of patients. Statistical summary of our results concerning SVR confirmed better efficiency of combination therapy for the following parameters compared to other investigated variables: age ?40 (84.3% vs. 59.l%; p<0.0005), absence of cirrhosis (75.6% vs. 58.3%; p=0.003), lack of genotype 1 (86.6% vs. 61.8%; p<0.0005), and in patients who received full doses of pegylated interferon alpha 2a (78.3% vs. 63.3%; p=0.002). Conclusion. Combination therapy of recombinant pegylated interferon alpha 2a with ribavirin leads to SVR in the majority of treated patients (70.5%). Successful treatment depends on a variety of host and virus factors.

scholarly journals Ischemic Colitis During Pegylated Interferon-Alpha and Ribavirin Therapy for Chronic Hepatitis C

2006 ◽  
Vol 20 (10) ◽  
pp. 661-663 ◽  
Author(s):  
Yvette Leung ◽  
Stefan J Urbanski ◽  
Lynn Schindel ◽  
Robert P Myers
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Interferon Alpha ◽  
Ischemic Colitis ◽  
Infected Patient ◽  
Metastatic Cancer ◽  
Pegylated Interferon ◽  
Pegylated Interferon Alpha ◽  
First Case

Rare cases of ischemic colitis associated with interferon-alpha (IFN-α) treatment for chronic hepatitis C (HCV) infection and metastatic cancer have been reported. The present study describes the first case of ischemic colitis attributable to pegylated IFN-α and ribavirin combination therapy in an HCV-infected patient after 34 weeks of treatment. The clinical presentation, endoscopic appearance and histopathology of the colon were consistent with ischemic colitis, and the patient’s symptoms rapidly resolved with cessation of therapy. The association between the therapy and the pathogenesis of ischemic colitis is unclear, but immunoregulatory, vasospastic and procoagulant mechanisms have been proposed. Physicians should be aware of this complication, and should consider it in any HCV-infected patient taking pegylated IFN-α and ribavirin who develops abdominal discomfort and gastrointestinal bleeding.

HCV-RNA and inflammasome is modulated by PEGylated interferon (PEG-IFNα-2b) monotherapy in chronic hepatitis c patients

2010 ◽  
Vol 43 (9) ◽  
pp. 781 ◽  
Author(s):  
G. Neuman Manuela ◽  
Gadi G. Katz ◽  
Ankit Patel ◽  
M. Izabella Malkiewicz ◽  
Rustan Esguerra
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Pegylated Interferon ◽  
Hcv Rna ◽  
Chronic Hepatitis C Patients

scholarly journals Secondary bronchiolitis obliterans organizing pneumonia during treatment of chronic hepatitis C: role of pegylated interferon alfa-2a

2012 ◽  
Vol 45 (5) ◽  
pp. 655-656 ◽  
Author(s):  
Ronaldo Soares Martins ◽  
Juliano Antunes Machado ◽  
Rosângela Teixeira
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Bronchiolitis Obliterans ◽  
Neuropsychiatric Symptoms ◽  
Pegylated Interferon ◽  
Interferon Alfa ◽  
Organizing Pneumonia ◽  
Bronchiolitis Obliterans Organizing Pneumonia ◽  
Pegylated Interferon Alfa

The treatment of chronic hepatitis C has frequent side effects such as cytopenias and neuropsychiatric symptoms. However, pulmonary toxicity associated with interferon is rarely described. This paper describes the clinical case of a 67-year-old female patient with chronic hepatitis C who presented an acute onset of dry cough, dyspnoea, and fever 36 weeks after the use of pegylated interferon alfa-2a and ribavirin. The lung biopsy confirmed the diagnosis of a bronchiolitis obliterans organizing pneumonia (BOOP). Corticotherapy was initiated, with clinical and radiological improvement. This paper aims to advise physicians to this occasional, though severe, adverse event related to hepatitis C virus (HCV) treatment.

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