A krónikus B- és C-vírushepatitis antivirális kezelésének hazai tapasztalatai (1998-2004)

Alajos Pár, István Tornai, Ferenc Szalay

Research output: Article

9 Citations (Scopus)

Abstract

Introduction: In the past decade several multicentre, prospective, randomised trials revealed a significant progress in the therapy for chronic viral hepatitis, but limited and controversal data are available regarding the real value of the antiviral treatment in the everyday routine clinical praxis. Aim: A nation-wide retrospective analysis has been made of the antiviral therapy for patients with hepatitis B and C, who represented the entire patient population necessitating treatment in Hungary during a seven-year period. In addition, results of a prospective study for chronic hepatitis C patients were also presented. Patients and methods: A total of 220 patients with chronic hepatitis B treated with standard interferon α (112), pegylated interferon α 2a (23), or lamivudine (85) were investigated and assessed for the HBeAg seroconversion and/or undetectable HBV-DNA. Out of 2442 chronic hepatitits C patients, 333 were treated with standard interferon monotherapy, 1122 with standard interferon + ribavirin and 987 with pegilated interferon plus ribavirin combination for 6-12 months. In a prospective study, 69 patients with chronic hepatitis C were enrolled and treated with pegilated interferon α-2a plus ribavirin. The rate of sustained virological response, the predictors of outcome and the adverse effects of treatment were evaluated. Results: For HBV patients standard IFN provided 31%, PEG-IFN 30% and lamivudine 31-33% sustained virological response rate, respectively. In chronic hepatitis C, a continuous improvement was noted in sustained virological response, from 13% by interferon monotherapy, to 31% by pegilated interferon plus ribavirin combination, in the nation-wide retrospective study, while even a 48% sustained virological response was achieved in the prospective trial. The most important predictors of outcome were the 4-week "rapid" and the 12-week "early" virological responses, then the female sex, age, BMI and adherence. The most frequent complications of the antiviral treatment were cytopenias, haemolysis and depression, 9% of patients experienced adverse effects. Conclusion: The efficacy of antiviral treatment unlike HBV infection, in chronic HCV hepatitis gradually improved in our every-day clinical praxis, but the results are far poorer than those achieved in a prospective study. To manage the growing populations of hard-to-treat patients with chronic viral hepatitis, there is a need for more effective treatment modalities, including optimized, individualized dosing and novel antivirals.

Translated title of the contributionExperiences on antiviral treatment for chronic viral B and C hepatitis patients in Hungary. 1998-2004. A nationwide study
Original languageHungarian
Pages (from-to)819-826
Number of pages8
JournalOrvosi hetilap
Volume148
Issue number18
DOIs
Publication statusPublished - máj. 6 2007

Keywords

  • Antiviral treatment
  • Chronic viral hepatitis
  • HBV
  • HCV
  • National survey
  • Prospective study

ASJC Scopus subject areas

  • Medicine(all)

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