Article ID Journal Published Year Pages File Type
3314416 Journal of Hepatology 2007 8 Pages PDF
Abstract

Background/AimsRisks and benefits of antiviral therapy in HCV cirrhosis with portal hypertension are poorly known.MethodsWe performed a randomized controlled trial in 102 HCV patients with compensated cirrhosis and portal hypertension: 51 received 1 μg/kg/week of Pegylated-interferon α-2b and 51 Pegylated-interferon plus 800 mg/day of ribavirin up to 52 weeks.ResultsBy intention-to-treat analysis, five patients on monotherapy and eleven on combination therapy achieved a sustained virological response (9.8% vs. 21.6%, p = 0.06). The response was more frequent for genotypes 2 or 3 than genotype 1 (66.6% vs. 11.3%, p = 0.001). Genotype 1, who had low viral load at start of therapy, were HCV–RNA negative at 4 weeks, and were adherent to the scheduled therapy had a higher probability of sustained virological response. Patients with sustained virological response had less disease events compared to nonresponders (6.2% vs. 38.3%, p = 0.03 by log rank test) during follow-up.ConclusionsIn HCV cirrhosis with portal hypertension Peg-interferon plus ribavirin is a feasible treatment. Although the rate of viral eradication is modest, tailoring by genotype and early viral response allows to keep patients on treatment who are more likely to have viral eradication. Patients with viral eradication have fewer disease complications during follow-up.

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