A krónikus hepatitis C-vírus-fertozés hagyományos pegilált interferon+ribavirin és proteázgátló direkt antivirális hatású szerekkel kiegészített kezelésének mellékhatásai

Translated title of the contribution: Side-effects of pegylated interferon plus ribavirin therapy with or without protease inhibitor direct acting antiviral agents during treatment of chronic hepatitis C virus infection

B. Hunyady, Balázs Kovács, Zita Battyáni

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Hepatitis C virus (HCV) infection affects 2-3% of the population, approximately 170 million people worldwide, causing chronic HCV-related hepatitis with subsequent liver cirrhosis, hepatic failure, hepatocellular cancer, and liver-related mortality in a large number of patients. The gold standard therapy, pegylated interferon alpha in combination with ribavirin can eradicate hepatitis C virus infection in approx. 40% of treatment-naïve patients infected with HCV genotype G1, and only 15-20% of patients with previous treatment. Success rate is substantially improved with the development and registration of two direct acting anti-hepatitis C virus protease inhibitors (boceprevir and telaprevir) in the second decade of 21st century: combined with the standard therapy, almost three quarter of previously untreated, and more than half of previously unsuccessfully treated patients can achieve sustained viral response with protease inhibitor based triple therapies. A major barrier to successful treatment is the association of peginterferon/ribavirin therapy with frequent and sometimes serious adverse effects. In clinical trials, approximately 10-15% of treated patients discontinue peginterferon and ribavirin due to adverse events; however, in routine clinical practice, the rate of treatment discontinuation has been reported to be substantially higher. The side effects of peginterferon/ribavirin therapy affect virtually all organ systems, and addition of protease inhibitor can amplify these side effects (particularly anemia), and/or may lead to new ones (i.e., dysgeusia with boceprevir or skin rush with telaprevir). There is considerable regional and global variability in the nature and prevalence of these adverse effects as well as in the best strategies to ameliorate their impact on hepatitis C virus treatment. This article summarizes the side effects of dual and triple therapies and their management based on the labels of the drugs, on a comprehensive literature review, as well as on the recently published opinion of an international panel of experts-with the provision of providing help for the physicians treating hepatitis C virus infection to achieve the best possible success with the highest possible safety for the patients.

Original languageHungarian
Pages (from-to)1997-2009
Number of pages13
JournalOrvosi Hetilap
Volume152
Issue number50
DOIs
Publication statusPublished - Dec 1 2011

Fingerprint

Ribavirin
Chronic Hepatitis C
Virus Diseases
Protease Inhibitors
Hepacivirus
Interferons
Antiviral Agents
Therapeutics
Liver Neoplasms
Dysgeusia
Liver Failure
Patient Safety
Interferon-alpha
Liver Cirrhosis
Hepatitis
Anemia
Genotype
Clinical Trials
Physicians

ASJC Scopus subject areas

  • Medicine(all)

Cite this

@article{055b73d00487436b9b6fce31a48526e8,
title = "A kr{\'o}nikus hepatitis C-v{\'i}rus-fertoz{\'e}s hagyom{\'a}nyos pegil{\'a}lt interferon+ribavirin {\'e}s prote{\'a}zg{\'a}tl{\'o} direkt antivir{\'a}lis hat{\'a}s{\'u} szerekkel kieg{\'e}sz{\'i}tett kezel{\'e}s{\'e}nek mell{\'e}khat{\'a}sai",
abstract = "Hepatitis C virus (HCV) infection affects 2-3{\%} of the population, approximately 170 million people worldwide, causing chronic HCV-related hepatitis with subsequent liver cirrhosis, hepatic failure, hepatocellular cancer, and liver-related mortality in a large number of patients. The gold standard therapy, pegylated interferon alpha in combination with ribavirin can eradicate hepatitis C virus infection in approx. 40{\%} of treatment-na{\"i}ve patients infected with HCV genotype G1, and only 15-20{\%} of patients with previous treatment. Success rate is substantially improved with the development and registration of two direct acting anti-hepatitis C virus protease inhibitors (boceprevir and telaprevir) in the second decade of 21st century: combined with the standard therapy, almost three quarter of previously untreated, and more than half of previously unsuccessfully treated patients can achieve sustained viral response with protease inhibitor based triple therapies. A major barrier to successful treatment is the association of peginterferon/ribavirin therapy with frequent and sometimes serious adverse effects. In clinical trials, approximately 10-15{\%} of treated patients discontinue peginterferon and ribavirin due to adverse events; however, in routine clinical practice, the rate of treatment discontinuation has been reported to be substantially higher. The side effects of peginterferon/ribavirin therapy affect virtually all organ systems, and addition of protease inhibitor can amplify these side effects (particularly anemia), and/or may lead to new ones (i.e., dysgeusia with boceprevir or skin rush with telaprevir). There is considerable regional and global variability in the nature and prevalence of these adverse effects as well as in the best strategies to ameliorate their impact on hepatitis C virus treatment. This article summarizes the side effects of dual and triple therapies and their management based on the labels of the drugs, on a comprehensive literature review, as well as on the recently published opinion of an international panel of experts-with the provision of providing help for the physicians treating hepatitis C virus infection to achieve the best possible success with the highest possible safety for the patients.",
keywords = "adverse drug reaction, boceprevir, direct acting antiviral agents, hepatitis C virus, pegylated interferon, ribavirin, telaprevir, viral hepatitis",
author = "B. Hunyady and Bal{\'a}zs Kov{\'a}cs and Zita Batty{\'a}ni",
year = "2011",
month = "12",
day = "1",
doi = "10.1556/OH.2011.29266",
language = "Hungarian",
volume = "152",
pages = "1997--2009",
journal = "Orvosi Hetilap",
issn = "0030-6002",
publisher = "Akademiai Kiado",
number = "50",

}

TY - JOUR

T1 - A krónikus hepatitis C-vírus-fertozés hagyományos pegilált interferon+ribavirin és proteázgátló direkt antivirális hatású szerekkel kiegészített kezelésének mellékhatásai

AU - Hunyady, B.

AU - Kovács, Balázs

AU - Battyáni, Zita

PY - 2011/12/1

Y1 - 2011/12/1

N2 - Hepatitis C virus (HCV) infection affects 2-3% of the population, approximately 170 million people worldwide, causing chronic HCV-related hepatitis with subsequent liver cirrhosis, hepatic failure, hepatocellular cancer, and liver-related mortality in a large number of patients. The gold standard therapy, pegylated interferon alpha in combination with ribavirin can eradicate hepatitis C virus infection in approx. 40% of treatment-naïve patients infected with HCV genotype G1, and only 15-20% of patients with previous treatment. Success rate is substantially improved with the development and registration of two direct acting anti-hepatitis C virus protease inhibitors (boceprevir and telaprevir) in the second decade of 21st century: combined with the standard therapy, almost three quarter of previously untreated, and more than half of previously unsuccessfully treated patients can achieve sustained viral response with protease inhibitor based triple therapies. A major barrier to successful treatment is the association of peginterferon/ribavirin therapy with frequent and sometimes serious adverse effects. In clinical trials, approximately 10-15% of treated patients discontinue peginterferon and ribavirin due to adverse events; however, in routine clinical practice, the rate of treatment discontinuation has been reported to be substantially higher. The side effects of peginterferon/ribavirin therapy affect virtually all organ systems, and addition of protease inhibitor can amplify these side effects (particularly anemia), and/or may lead to new ones (i.e., dysgeusia with boceprevir or skin rush with telaprevir). There is considerable regional and global variability in the nature and prevalence of these adverse effects as well as in the best strategies to ameliorate their impact on hepatitis C virus treatment. This article summarizes the side effects of dual and triple therapies and their management based on the labels of the drugs, on a comprehensive literature review, as well as on the recently published opinion of an international panel of experts-with the provision of providing help for the physicians treating hepatitis C virus infection to achieve the best possible success with the highest possible safety for the patients.

AB - Hepatitis C virus (HCV) infection affects 2-3% of the population, approximately 170 million people worldwide, causing chronic HCV-related hepatitis with subsequent liver cirrhosis, hepatic failure, hepatocellular cancer, and liver-related mortality in a large number of patients. The gold standard therapy, pegylated interferon alpha in combination with ribavirin can eradicate hepatitis C virus infection in approx. 40% of treatment-naïve patients infected with HCV genotype G1, and only 15-20% of patients with previous treatment. Success rate is substantially improved with the development and registration of two direct acting anti-hepatitis C virus protease inhibitors (boceprevir and telaprevir) in the second decade of 21st century: combined with the standard therapy, almost three quarter of previously untreated, and more than half of previously unsuccessfully treated patients can achieve sustained viral response with protease inhibitor based triple therapies. A major barrier to successful treatment is the association of peginterferon/ribavirin therapy with frequent and sometimes serious adverse effects. In clinical trials, approximately 10-15% of treated patients discontinue peginterferon and ribavirin due to adverse events; however, in routine clinical practice, the rate of treatment discontinuation has been reported to be substantially higher. The side effects of peginterferon/ribavirin therapy affect virtually all organ systems, and addition of protease inhibitor can amplify these side effects (particularly anemia), and/or may lead to new ones (i.e., dysgeusia with boceprevir or skin rush with telaprevir). There is considerable regional and global variability in the nature and prevalence of these adverse effects as well as in the best strategies to ameliorate their impact on hepatitis C virus treatment. This article summarizes the side effects of dual and triple therapies and their management based on the labels of the drugs, on a comprehensive literature review, as well as on the recently published opinion of an international panel of experts-with the provision of providing help for the physicians treating hepatitis C virus infection to achieve the best possible success with the highest possible safety for the patients.

KW - adverse drug reaction

KW - boceprevir

KW - direct acting antiviral agents

KW - hepatitis C virus

KW - pegylated interferon

KW - ribavirin

KW - telaprevir

KW - viral hepatitis

UR - http://www.scopus.com/inward/record.url?scp=82455186322&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=82455186322&partnerID=8YFLogxK

U2 - 10.1556/OH.2011.29266

DO - 10.1556/OH.2011.29266

M3 - Article

C2 - 22112373

AN - SCOPUS:82455186322

VL - 152

SP - 1997

EP - 2009

JO - Orvosi Hetilap

JF - Orvosi Hetilap

SN - 0030-6002

IS - 50

ER -