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Is
Alfa-Interferon Therapy Safe and Effective for HCV Patients
with Inflammatory Bowel Disease?
Hepatitis C virus infection is more common in patients with inflammatory
bowel disease than in the general population. Limited data
are available as to the safety and efficacy of alfa-interferon
therapy for chronic
active hepatitis C in patients with concomitant
inflammatory bowel disease.
The
aim of the current study was to evaluate the efficacy and
safety of alfa-interferon
monotherapy in patients with chronic active
hepatitis C and inactive or mildly active inflammatory bowel
disease.
A
total of 513 consecutive inflammatory bowel disease patients
at a single centre were tested for antibodies to hepatitis
C virus (anti-hepatitis C virus) between 1995 and 2000.
Twenty-one
patients had detectable anti-hepatitis C virus Ab and were
hepatitis C virus-RNA positive with histologically proved
chronic active hepatitis. Each of these patients, whose inflammatory
bowel disease was in clinical remission or mildly active,
was sex- and age-matched to three controls with similar histological
grade and stage of chronic hepatitis C virus but without inflammatory
bowel disease; and all were treated with human leucocyte alfa-interferon
6 million units given thrice weekly for 12 months.
Responses
to treatment were classified as follows: complete response--persistently
normal alanine
aminotransferase and viral
clearance (hepatitis C virus-RNA negative)
at the end-of-treatment, incomplete response--alanine aminotransferase
normalization without viral clearance (hepatitis C virus-RNA
positive), and sustained
response--alanine aminotransferase normalization
and hepatitis C virus clearance 12 months after the end-of-treatment.
Results
· Twenty-one
patients with chronic active hepatitis C and inflammatory
bowel disease (10 with Crohn's disease and 11 with ulcerative
colitis) and 63 sex- and age-matched controls with chronic
hepatitis C virus alone received alfa-interferon monotherapy.
· Response
rates to interferon were similar for inflammatory bowel disease
patients compared with controls [CR 42% vs. 35% and SR 24%
vs. 18% (P, not significant), respectively].
· None
of the 21 inflammatory bowel disease patients had severe adverse
effects and the mild ones observed were comparable with those
seen in the control group.
· No
patients developed an inflammatory bowel disease relapse during
the interferon treatment period or in the 12 months thereafter.
According
to the authors, the biochemical and virological response to
a 12-month human leucocyte alfa-interferon treatment in patients
with chronic active hepatitis C are similar to that observed
in matched controls with chronic hepatitis C virus without
inflammatory bowel disease.
Adverse
effects were similar in both groups of patients and unrelated
to the underlying inflammatory bowel condition.
The
authors conclude, “This provides hepatologists with evidence
that alfa-interferon can be safely administered to patients
with chronic hepatitis C virus and inflammatory bowel disease
provided that the inflammatory bowel condition is in clinical
remission.”
Academic Department of Gastroenterology,
L.Sacco University Hospital, Milan, Italy.
09/12/05
Reference
S
Bargiggia and others. Is interferon-alpha therapy safe and
effective for patients with chronic hepatitis C and inflammatory
bowel disease? A case-control study. Aliment Pharmacol Ther 22(3):
209-215. August 1, 2005.
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