Treatment of hepatitis C virus carriers with persistently normal alanine aminotransferase levels with peginterferon α-2a and ribavirin: a multicentric study
Claudio Puoti
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorAdriano M. Pellicelli
Liver Unit, San Camilllo Hospital, Rome, Italy
Search for more papers by this authorFabrizio Mecenate
Liver Unit, Villa Betania Hospital, Rome, Italy
Search for more papers by this authorRiccardo Guarisco
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorGiorgio Barbarini
Department of Infectious Diseases, San Matteo Hospital, Pavia, Italy
Search for more papers by this authorEttore Mazzoni
Liver Unit, Policlinico Casilino Hospital, Rome, Italy
Search for more papers by this authorLucia Spilabotti
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorLia Bellis
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorFederica Paglia
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorAngelo Barlattani
Department of Internal Medicine, San Giacomo Hospital, Rome, Italy
Search for more papers by this authorAntonio Picardi
Liver Unit, Campus Biomedico University, Rome, Italy
Search for more papers by this authorAmerigo Paffetti
Department of Infectious Diseases, University “La Sapienza”, Rome, Italy
Search for more papers by this authorMaria Elena Bonaventura
Department of Infectious Diseases, Rieti Hospital, Rieti, Italy
Search for more papers by this authorLorenzo Nosotti
Department of Preventive Medicine of Migration, San Gallicano Hospital, Rome, Italy
Search for more papers by this authorOlga Mitidieri
Molecular Virology Unit, Marino General Hospital, Rome, Italy
Search for more papers by this authorOrlando Dell' Unto
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorChiara Dell' Unto
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorAldo Morrone
National Institute for Health, Migrants and Poverty, Rome, Italy
Search for more papers by this authorFabrizio Soccorsi
Liver Unit, San Camilllo Hospital, Rome, Italy
Search for more papers by this authoron behalf of the Club Epatologico Ospedaliero (Hospital Liver Club – CLEO)
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorClaudio Puoti
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorAdriano M. Pellicelli
Liver Unit, San Camilllo Hospital, Rome, Italy
Search for more papers by this authorFabrizio Mecenate
Liver Unit, Villa Betania Hospital, Rome, Italy
Search for more papers by this authorRiccardo Guarisco
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorGiorgio Barbarini
Department of Infectious Diseases, San Matteo Hospital, Pavia, Italy
Search for more papers by this authorEttore Mazzoni
Liver Unit, Policlinico Casilino Hospital, Rome, Italy
Search for more papers by this authorLucia Spilabotti
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorLia Bellis
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorFederica Paglia
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorAngelo Barlattani
Department of Internal Medicine, San Giacomo Hospital, Rome, Italy
Search for more papers by this authorAntonio Picardi
Liver Unit, Campus Biomedico University, Rome, Italy
Search for more papers by this authorAmerigo Paffetti
Department of Infectious Diseases, University “La Sapienza”, Rome, Italy
Search for more papers by this authorMaria Elena Bonaventura
Department of Infectious Diseases, Rieti Hospital, Rieti, Italy
Search for more papers by this authorLorenzo Nosotti
Department of Preventive Medicine of Migration, San Gallicano Hospital, Rome, Italy
Search for more papers by this authorOlga Mitidieri
Molecular Virology Unit, Marino General Hospital, Rome, Italy
Search for more papers by this authorOrlando Dell' Unto
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorChiara Dell' Unto
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorAldo Morrone
National Institute for Health, Migrants and Poverty, Rome, Italy
Search for more papers by this authorFabrizio Soccorsi
Liver Unit, San Camilllo Hospital, Rome, Italy
Search for more papers by this authoron behalf of the Club Epatologico Ospedaliero (Hospital Liver Club – CLEO)
Department of Internal Medicine and Liver Unit, Marino Hospital, Rome, Italy
Search for more papers by this authorAbstract
Background/Aims: To evaluate, in clinical practice, the efficacy and safety of combined antiviral treatment in hepatitis C virus (HCV) carriers with normal alanine aminotransferase (ALT) levels.
Methods: Eighty-eight HCV carriers with persistently normal ALT levels were enrolled. All patients received peginterferon (PEG-IFN) α-2a 180 μg once weekly plus ribavirin (RBV) 800 mg/day for 24 weeks (HCV-2 and -3) or 1000–1200 mg/day for 48 weeks (HCV-1).
Results: Rapid virological response (RVR) was seen in 66/88 patients (75%): 19/32 HCV-1 (59%), 40/46 HCV-2 (87%) and 7/10 HCV-3 patients. Younger patients, leaner subjects and patients with non-1 genotype or lower baseline HCV RNA levels were more likely to achieve an RVR. Sustained virological response (SVR) was seen in 69/88 patients (78%): 20/32 HCV-1 patients (62%), 41/46 HCV-2 patients (89%) and 8/10 (80%) HCV-3 patients. The overall SVR rate was 88% in patients with RVR (58/66) and 50% in those without RVR.
Conclusions: The combination of PEG-IFN α-2a and RBV produces, in patients with normal ALT, virological response rates that are comparable or even higher than those obtained in patients with elevated ALT levels. Thus, we suggest that in selected cases immediate therapy might be preferred to a ‘wait-and-see’ policy.
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