Virological sustained response to former young intravenous drug abusers with chronic hepatitis C treated by pegylated interferon-α plus ribavirin

Czech version

Authors: K. Gazdíková ¹; †f. Gazdík ²; I. Kajaba ¹; D. Hučková ³; D. Daniš ⁴; Ľ. Okruhlica ⁵
Authors‘ workplace: Fakulta ošetrovateľstva a zdravotníckych odborných štúdií Slovenskej zdravotníckej univerzity Bratislava, Slovenská republika, rektorka Dr. h. c. prof. PhDr. Dana Farkašová, CSc. ¹; Oddelenie imunológie a imunotoxikológie Slovenskej zdravotníckej univerzity Bratislava, Slovenská republika, rektorka Dr. h. c. prof. PhDr. Dana Farkašová, CSc. ²; HPL spol. s r. o., Bratislava, Slovenská republika, riaditeľ MUDr. Juraj Hanzen ³; Ústav patológie Slovenskej zdravotníckej univerzity Bratislava, Slovenská republika, rektorka Dr. h. c. prof. PhDr. Dana Farkašová, CSc. ⁴; Inštitút drogových závislostí, Centrum pre liečbu drogových závislostí Bratislava, Slovenská republika, riaditeľ MUDr. Ľubomír Okruhlica, PhD. ⁵
Published in: Vnitř Lék 2012; 58(2): 104-109
Category: Original Contributions

Overview

Introduction:
The most risk group with high rate of infection of viral hepatitis C represents the former drug abusers (IDUs).

Objectives:
The objectives of the clinical study were to assess the sustained virological response (SVR) in the group of former IDUs with chronic hepatitis C (CHC) treated with pegylated interferon-α and ribavirin.

Patients and methods:
Of 293 previously untreated (naive) former IDUs with CHC who have started treatment, we assessed 239 (69 women, 170 men) with an average age of 27 years who completed treatment and received a follow-up examination after 24 weeks. Prior to therapy abstinence to drug abuse 6 and more months has been required. The CHC has been diagnostics by the standard virological diagnostic tests, increased activity of aminotranferases (ALT) and histology of liver biopsy. Patients were treated with combined immunomodulatory therapy in the standard duration and standard regimen. SVR was considered if qualitative test HCV RNA was negative 24 weeks after the completion of the treatment.

Results:
End-of-treatment virological response was in 224/94 % patients. Overall SVR rate was 95 %, 227 subjects had negative HCV RNA and only 12 patients no response. During treatment there was a statistically significant decrease in ALT. Treatment was accompanied by the expected side effects.

Conclusion:
Young age, short duration of HCV infection, high prevalence of genotype 3 and low grade of liver fibrosis in majority of patients and good adherence of patients to treatment were crucial predictive factors resulting in high SVR.

Key words:
chronic hepatitis C – pegylated interferon-α – ribavirin – former intravenous drug abusers

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