The use of peginterferon in monotherapy or in combination with ribavirin for the treatment of acute hepatitis C

G. Nunnari 1, A. Montineri 2, V. Portelli 3, F. Savalli 3, F. Fatuzzo 2, B. Cacopardo 1

1 Department of Clinical and Molecular Biomedicine, Division of Infectious Diseases, University of Catania, Catania, Italy. cacopard@unict.it  2 Infectious Diseases Unit, Ferrarotto Hospital, Catania, Italy
3 Infectious Diseases Unit, S. Antonio Hospital, Trapani, Italy

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• Pharmacology

BACKGROUND: Acute hepatitis C becomes chronic in 50% of cases. Early treatment seems to be effective in eradicating HCV infection, although no clear recommendations are available in terms of time of initiation, regimen and duration of therapy. We report a retrospective review of 48 patients with acute HCV infection between January 2006 and December 2007.

PATIENTS AND METHODS: This multicenter retrospective study involved three Infectious Disease Units in Sicily and was carried out in three stages: (1) Collection of patients data; (2) Selection of patients according to: elevated ALT (at least 5 times above normal values), seroconversion from negative to positive anti-HCV status; (3) Final selection of patients with a minimum of 12 months follow-up.

RESULTS: Out of 60 patients with a diagnosis of acute HCV infection, 48 were eligible for the study. In 13 subjects (52%) of the 25 who were not treated, the disease resolved spontaneously. 23 patients received pegylated interferon in monotherapy or in combination with ribavirin. 95% achieved a sustained virological response (SVR). Of the 22 sustained responders, 17 (70%) negativized HCV RNA within 8 weeks. No difference appeared between patients receiving monotherapy and those treated with combination therapy. Also, no difference was observed, in terms of SVR, between the two different pegylated interferons given for treatment.

CONCLUSIONS: The rate of viral clearance was higher in the treated group versus the untreated one (95% versus 52%). The SVR found in our study population (95%) was comparable to that reported in other studies. The combination with ribavirin did not appear to impact our sustained response rate, although ribavirin appeared to induce a faster normalization of ALT levels.

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