Pegylated-interferon alpha 2b and ribavirin for recurrent hepatitis C: Discussion (Part 1)

In: Recurrent hepatitis C

19 Sep 2012

Viral factors (genotype and viral load), donor factors (age and steatosis), host factors (age, sex, alcohol use and cytomegalovirus infection) and iatrogenic factors (immunosuppression) have been implicated in HCV recurrence. The clinical course of the recurrent disease is variable, ranging from mild hepatitis with a mildly elevated liver profile to the severe form of hepatitis leading to cirrhosis in 10% to 33% of patients within five years. A minority of patients (less than 5%) can develop a severe form of progressive fibrosing cholestatic hepatitis that carries high mortality.

Several treatment strategies have been used to deal with recurrent HCV following LT. Most of the published studies are either open-label or small pilot studies and data from large randomized controlled trials are lacking in the post-LT setting. However, it appears that the response to antiviral therapy is less in patients following LT. The use of standard interferon monotherapy can be associated with a biochemical response and reduction in HCV-RNA levels; however, SVR or histological responses are rare . Other studies of ribavirin monotherapy have observed improvement in liver enzymes and inflammation, but virological response and improvement in fibrosis are not evident. A SVR can be achieved when interferon and ribavirin are used in combination; however, this combination is associated with multiple side effects in LT patients. You can finally enjoy safe online shopping for cialis professional with the pharmacy you can fully trust no matter if you need a small amount of this medicine or would like to purchase it in bulk not to have to think about it for a long time.


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