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The safety and efficacy of peginterferon plus ribavirin in hepatitis C patients concomitant with malignancy other than hepatocellular carcinoma: a multicenter study

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Abstract

Purpose

Cancer patients were generally excluded from the therapeutic guidelines of antiviral therapy. We aimed to evaluate the efficacy and safety of antiviral therapy in patients with hepatitis C virus (HCV) infection concomitant with malignancy other than hepatocellular carcinoma (HCC).

Methods

Twenty-five HCV patients with curative malignancy other than HCC (group A) and 75 sex- and age-matched controls (group B) were recruited into a prospective and case–control analysis. All patients received peginterferon-alpha-2a (PegIFN-alpha-2a) and weight-based ribavirin according to the current treatment recommendations. The primary outcome measurement was sustained virological response (SVR). The safety issue between groups was also compared.

Results

There were 22 (88.0 %) patients of group A and 59 (78.7 %) patients of group B who achieved an SVR (p = 0.39). The SVR rate was comparable between groups both in genotype-1 (HCV-1) (81.8 vs. 72.7 %, p = 0.70) and in genotype-2 (HCV-2) (92.9 vs. 83.3 %, p = 0.66) patients. Multivariate logistic regression analysis demonstrated that the achievement of a RVR (viral clearance during first 4 weeks of treatment) was the strongest predictor of an SVR (odds ratio/95 % confidence intervals [OR/CI]: 6.357/1.50 − 26.99, p = 0.01), followed by lower baseline viral loads (OR/CI: 0.403/0.174 − 0.936, p = 0.034) and higher dose of ribavirin exposure (OR/CI: 1.287/1.092 − 1.517, p = 0.003), whilst previous occurrence of cancer was not associated with SVR. Treatment adherence (76.0 vs. 72.0 %, p = 0.70) and the incidences of grade 3 or more adverse events (28.0 vs. 20.0 %, p = 0.40) were comparable between two groups.

Conclusions

Chronic hepatitis C patients with non-HCC malignancies receiving peginterferon/ribavirin combination therapy carried favorable efficacy and safety outcomes.

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Abbreviations

HCV:

Hepatitis C virus

CHC:

Chronic HCV infection

HCC:

Hepatocellular carcinoma

PegIFN:

Pegylated interferon

RBV:

Ribavirin

LC:

Liver cirrhosis

G-1:

Genotype 1

G-2/3:

Genotype 2 or 3

SVR:

Sustained virological response

RVR:

Rapid virological response

ETR:

End-of-treatment virological response

ALT:

Alanine aminotransferase

AE:

Adverse event

SAE:

Severe adverse event

BMI:

Body mass index

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Conflict of interest

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Author information

Authors and Affiliations

  1. Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Chung-Feng Huang, Jee-Fu Huang, Ming-Lun Yeh, Ching-I Huang, Jeng-Fu Yang, Wan-Long Chuang, Chia-Yen Dai, Zu-Yau Lin, Shinn-Cherng Chen & Ming-Lung Yu

  2. Department of Occupational Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Chung-Feng Huang

  3. Department of Preventive Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan

    Chung-Feng Huang & Wu-Cheng Chen

  4. Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan

    Jee-Fu Huang

  5. Faculty of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Jee-Fu Huang, Wan-Long Chuang, Chia-Yen Dai, Zu-Yau Lin, Shinn-Cherng Chen & Ming-Lung Yu

  6. Department of Preventive Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Jeng-Fu Yang

  7. Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

    Ming-Yen Hsieh & Ming-Lung Yu

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  1. Chung-Feng Huang
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Correspondence to Ming-Lung Yu.

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Huang, CF., Huang, JF., Chen, WC. et al. The safety and efficacy of peginterferon plus ribavirin in hepatitis C patients concomitant with malignancy other than hepatocellular carcinoma: a multicenter study. Hepatol Int 7, 180–187 (2013). https://doi.org/10.1007/s12072-012-9394-z

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  • DOI: https://doi.org/10.1007/s12072-012-9394-z

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