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Improved virologic response in chronic hepatitis C genotype 4 treated with nitazoxanide, peginterferon, and ribavirin.
- Source :
-
Gastroenterology [Gastroenterology] 2009 Mar; Vol. 136 (3), pp. 856-62. Date of Electronic Publication: 2008 Nov 19. - Publication Year :
- 2009
-
Abstract
- Background & Aims: Sustained virologic response (SVR) rates of 50%-60% have been achieved in patients with chronic hepatitis C genotype 4 treated with peginterferon plus ribavirin. The safety and efficacy of nitazoxanide plus peginterferon alfa-2a, with or without ribavirin, were evaluated in a randomized controlled trial at 2 centers in Egypt.<br />Methods: Previously untreated patients with chronic hepatitis C and genotype 4 infection were assigned randomly to groups that were given standard of care (peginterferon alfa-2a and ribavirin for 48 weeks, n = 40), nitazoxanide monotherapy for 12 weeks followed by nitazoxanide plus peginterferon alfa-2a for 36 weeks (n = 28), or nitazoxanide monotherapy for 12 weeks followed by nitazoxanide plus peginterferon alfa-2a and ribavirin for 36 weeks (n = 28). Therapeutics included nitazoxanide (500 mg) twice daily, peginterferon alfa-2a (180 microg) once weekly, and weight-based ribavirin (1000-1200 mg/day).<br />Results: The percentages of rapid virologic response (RVR), defined as undetectable HCV RNA at week 4 of combination therapy, and SVR were significantly higher in patients given the triple therapy compared with the standard of care (64% vs 38%, P = .048; and 79% vs 50%, P = .023; respectively). Patients given nitazoxanide plus peginterferon alfa-2a had intermediate rates of RVR (54%) and SVR (61%). Adverse events were similar across treatment groups except for higher rates of anemia in the groups receiving ribavirin.<br />Conclusions: The combination of nitazoxanide, peginterferon alfa-2a, and ribavirin increased the percentages of patients with RVR and SVR, compared with patients given peginterferon plus ribavirin, without an increase in adverse events.
- Subjects :
- Adult
Antiparasitic Agents administration & dosage
Antiparasitic Agents adverse effects
Antiviral Agents adverse effects
Drug Therapy, Combination
Female
Genotype
Hepacivirus genetics
Humans
Interferon alpha-2
Interferon-alpha adverse effects
Male
Middle Aged
Nitro Compounds
Polyethylene Glycols adverse effects
Recombinant Proteins
Ribavirin adverse effects
Thiazoles adverse effects
Treatment Outcome
Young Adult
Antiviral Agents administration & dosage
Hepacivirus drug effects
Hepatitis C, Chronic drug therapy
Interferon-alpha administration & dosage
Polyethylene Glycols administration & dosage
Ribavirin administration & dosage
Thiazoles administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1528-0012
- Volume :
- 136
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 19135998
- Full Text :
- https://doi.org/10.1053/j.gastro.2008.11.037