Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2011
Safety and efficacy of peginterferon alpha plus ribavirin in patients with chronic hepatitis C and coexisting heart disease.
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Durante-Mangoni Emanuele, Iossa Domenico, Pinto Daniela, De Vincentiis Lucia, Ragone Enrico, Utili Riccardo
Аннотация
BACKGROUND: Chronic hepatitis C patients with coexisting heart disease are often denied antiviral treatment due to safety concerns. However, this is not evidence-based.
AIMS: To evaluate safety and efficacy of pegylated interferon and ribavirin in chronic hepatitis C patients with heart disease.
METHODS: Patients with overt heart disease (ischaemic heart disease, prior mechanical heart valve replacement, chronic arrhythmias and cardiomyopathy) and chronic hepatitis C were treated with standard pegylated interferon/ribavirin doses for standard duration. Cardiovascular safety was monitored by electrocardiography, echocardiography and measurement of troponin and B-type natriuretic peptide.
RESULTS: Twenty-three patients (65.2% male, median age 57 years, 47.8% genotype 1) were treated. Three patients (13%) suspended treatment prematurely; 52% obtained sustained virological response, 39% relapsed, 9% were non-responders. No serious adverse event was observed. Post-treatment clinical examination, electrocardiography and echocardiography did not show any sign of progression of the pre-existing heart disease.
CONCLUSIONS: Treatment with pegylated interferon/ribavirin may be safely offered to carefully selected chronic hepatitis C patients with coexisting, clinically significant heart disease. In these patients, the outcome of antiviral treatment overlaps that observed in other patient subgroups.
AIMS: To evaluate safety and efficacy of pegylated interferon and ribavirin in chronic hepatitis C patients with heart disease.
METHODS: Patients with overt heart disease (ischaemic heart disease, prior mechanical heart valve replacement, chronic arrhythmias and cardiomyopathy) and chronic hepatitis C were treated with standard pegylated interferon/ribavirin doses for standard duration. Cardiovascular safety was monitored by electrocardiography, echocardiography and measurement of troponin and B-type natriuretic peptide.
RESULTS: Twenty-three patients (65.2% male, median age 57 years, 47.8% genotype 1) were treated. Three patients (13%) suspended treatment prematurely; 52% obtained sustained virological response, 39% relapsed, 9% were non-responders. No serious adverse event was observed. Post-treatment clinical examination, electrocardiography and echocardiography did not show any sign of progression of the pre-existing heart disease.
CONCLUSIONS: Treatment with pegylated interferon/ribavirin may be safely offered to carefully selected chronic hepatitis C patients with coexisting, clinically significant heart disease. In these patients, the outcome of antiviral treatment overlaps that observed in other patient subgroups.
Предметные рубрики MeSH
AdultAgedAntiviral AgentsDisease ProgressionEchocardiographyElectrocardiographyFemaleGenotypeHeart DiseasesHepacivirusHepatitis C, ChronicHumansInsulin ResistanceInterferon alpha-2Interferon-alphaMaleMiddle AgedNatriuretic Peptide, BrainPeptide FragmentsPolyethylene GlycolsRecombinant ProteinsRibavirinTreatment OutcomeTroponin I