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[Experiences in antiviral treatment of chronic viral hepatitis B and C in Hungary (1998-2004)].

Abstract

INTRODUCTION

In the past decade several multicentre, prospective, randomised trials revealed a significant progress in the therapy for chronic viral hepatitis, but limited and controversial data are available regarding the real value of the antiviral treatment in the everyday routine clinical praxis.

AIM

A nation-wide retrospective analysis has been made of the antiviral therapy for patients with hepatitis B and C, who represented the entire patient population necessitating treatment in Hungary during a seven-year period. In addition, results of a prospective study for chronic hepatitis C patients were also presented.

PATIENTS AND METHODS

A total of 220 patients with chronic hepatitis B treated with standard interferon alpha (112), pegylated interferon alpha-2a (23), or lamivudine (85) were investigated and assessed for the HBeAg seroconversion and/or undetectable HBV-DNA. Out of 2442 chronic hepatitis C patients, 333 were treated with standard interferon monotherapy, 1122 with standard interferon + ribavirin and 987 with pegylated interferon plus ribavirin combination for 6-12 months. In a prospective study, 69 patients with chronic hepatitis C were enrolled and treated with pegylated interferon alpha-2a plus ribavirin. The rate of sustained virological response, the predictors of outcome and the adverse effects of treatment were evaluated.

RESULTS

For HBV patients standard IFN provided 31%, PEG-IFN 30% and lamivudine 31-33% sustained virological response rate, respectively. In chronic hepatitis C, a continuous improvement was noted in sustained virological response, from 13% by interferon monotherapy, to 31% by pegylated interferon plus ribavirin combination, in the nation-wide retrospective study, while even a 48% sustained virological response was achieved in the prospective trial. The most important predictors of outcome were the 4-week "rapid" and the 12-week "early" virological responses, then the female sex, age, BMI and adherence. The most frequent complications of the antiviral treatment were cytopenias, haemolysis and depression, 9% of patients experienced adverse effects.

CONCLUSION

The efficacy of antiviral treatment unlike HBV infection, in chronic HCV hepatitis gradually improved in our every-day clinical praxis, but the results are far poorer than those achieved in a prospective study. To manage the growing populations of hard-to-treat patients with chronic viral hepatitis, there is a need for more effective treatment modalities, including optimized, individualized dosing and novel antivirals.

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  • Authors+Show Affiliations

    ,

    Pécsi Tudományegyetem, Altalános Orvostudományi Kar I. Belgyógyászati Klinika, Pécs. alajos.par@aok.pte.hu

    ,

    Source

    Orvosi hetilap 148:18 2007 May 06 pg 819-26

    MeSH

    Adult
    Aged
    Antiviral Agents
    Female
    Hepatitis B e Antigens
    Hepatitis B, Chronic
    Hepatitis C, Chronic
    Humans
    Hungary
    Interferon alpha-2
    Interferon-alpha
    Interferons
    Lamivudine
    Male
    Middle Aged
    Polyethylene Glycols
    RNA, Viral
    Recombinant Proteins
    Retrospective Studies
    Ribavirin
    Risk Factors
    Treatment Outcome

    Pub Type(s)

    Journal Article

    Language

    hun

    PubMed ID

    17468063

    Citation

    Pár, Alajos, et al. "[Experiences in Antiviral Treatment of Chronic Viral Hepatitis B and C in Hungary (1998-2004)]." Orvosi Hetilap, vol. 148, no. 18, 2007, pp. 819-26.
    Pár A, Tornai I, Szalay F. [Experiences in antiviral treatment of chronic viral hepatitis B and C in Hungary (1998-2004)]. Orv Hetil. 2007;148(18):819-26.
    Pár, A., Tornai, I., & Szalay, F. (2007). [Experiences in antiviral treatment of chronic viral hepatitis B and C in Hungary (1998-2004)]. Orvosi Hetilap, 148(18), pp. 819-26.
    Pár A, Tornai I, Szalay F. [Experiences in Antiviral Treatment of Chronic Viral Hepatitis B and C in Hungary (1998-2004)]. Orv Hetil. 2007 May 6;148(18):819-26. PubMed PMID: 17468063.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - [Experiences in antiviral treatment of chronic viral hepatitis B and C in Hungary (1998-2004)]. AU - Pár,Alajos, AU - Tornai,István, AU - Szalay,Ferenc, PY - 2007/5/1/pubmed PY - 2007/7/12/medline PY - 2007/5/1/entrez SP - 819 EP - 26 JF - Orvosi hetilap JO - Orv Hetil VL - 148 IS - 18 N2 - INTRODUCTION: In the past decade several multicentre, prospective, randomised trials revealed a significant progress in the therapy for chronic viral hepatitis, but limited and controversial data are available regarding the real value of the antiviral treatment in the everyday routine clinical praxis. AIM: A nation-wide retrospective analysis has been made of the antiviral therapy for patients with hepatitis B and C, who represented the entire patient population necessitating treatment in Hungary during a seven-year period. In addition, results of a prospective study for chronic hepatitis C patients were also presented. PATIENTS AND METHODS: A total of 220 patients with chronic hepatitis B treated with standard interferon alpha (112), pegylated interferon alpha-2a (23), or lamivudine (85) were investigated and assessed for the HBeAg seroconversion and/or undetectable HBV-DNA. Out of 2442 chronic hepatitis C patients, 333 were treated with standard interferon monotherapy, 1122 with standard interferon + ribavirin and 987 with pegylated interferon plus ribavirin combination for 6-12 months. In a prospective study, 69 patients with chronic hepatitis C were enrolled and treated with pegylated interferon alpha-2a plus ribavirin. The rate of sustained virological response, the predictors of outcome and the adverse effects of treatment were evaluated. RESULTS: For HBV patients standard IFN provided 31%, PEG-IFN 30% and lamivudine 31-33% sustained virological response rate, respectively. In chronic hepatitis C, a continuous improvement was noted in sustained virological response, from 13% by interferon monotherapy, to 31% by pegylated interferon plus ribavirin combination, in the nation-wide retrospective study, while even a 48% sustained virological response was achieved in the prospective trial. The most important predictors of outcome were the 4-week "rapid" and the 12-week "early" virological responses, then the female sex, age, BMI and adherence. The most frequent complications of the antiviral treatment were cytopenias, haemolysis and depression, 9% of patients experienced adverse effects. CONCLUSION: The efficacy of antiviral treatment unlike HBV infection, in chronic HCV hepatitis gradually improved in our every-day clinical praxis, but the results are far poorer than those achieved in a prospective study. To manage the growing populations of hard-to-treat patients with chronic viral hepatitis, there is a need for more effective treatment modalities, including optimized, individualized dosing and novel antivirals. SN - 0030-6002 UR - https://www.unboundmedicine.com/medline/citation/17468063/[Experiences_in_antiviral_treatment_of_chronic_viral_hepatitis_B_and_C_in_Hungary__1998_2004_]_ L2 - http://www.akademiai.com/doi/full/10.1556/OH.2007.28114?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -