3 research outputs found
Non-cirrhotic thrombocytopenic patients with hepatitis C virus: characteristics and outcome of antiviral therapy.
Background and Aim: Thrombocytopenia is frequently observed in patients with chronic
hepatitis C virus (HCV) infection and cirrhosis, although it can also be observed in patients
without cirrhosis by a virus-mediated phenomenon. This study assessed the prevalence,
characteristics, and outcomes of antiviral therapy in patients with chronic HCV infection
and thrombocytopenia not associated with cirrhosis.
Methods: The study included 1268 patients with HCV infection and thrombocytopenia
enrolled in the phase 3 ENABLE studies that assessed the impact of eltrombopag
on achieving a sustained virologic response to pegylated interferon and ribavirin. The
study population was subdivided according to baseline FibroSURE test results into
patients with non-cirrhosis (FibroSURE < 0.4) and cirrhosis-related (FibroSURE 65 0.75)
thrombocytopenia.
Results: Compared with patients with cirrhosis-related thrombocytopenia (n = 995;
78.5%), non-cirrhotic patients with thrombocytopenia (n = 59; 4.6%) were younger (mean
age [95% confidence interval (CI)]: 43.9 [40.7\u201347.2] vs 52.7 [52.2\u201353.3] years;
P < 0.0001), predominantly female (64% [51\u201376] vs 30% [27\u201333]; P < 0.0001), and less
frequently had a Model for End-Stage Liver Disease score 65 10 (24% [14\u201337] vs 45%
[42\u201349]; P = 0.0012), low albumin levels ( 64 35 g/L; 2% [0\u20139] vs 32% [29\u201335];
P < 0.0001), and prevalence of diabetes mellitus (3% [0\u201312] vs 21% [19\u201324]; P = 0.0005).
The sustained virologic response rate was higher in non-cirrhotic patients with thrombocytopenia
(46% [95% CI, 33\u201359] vs 16% [14\u201318]; P < 0.0001).
Conclusions: Patients with thrombocytopenia associated with HCV who have lower
FibroSURE test results may have better preserved liver function and higher sustained
virologic response rates than patients with cirrhosis
Combination of Tenofovir Disoproxil Fumarate and Peginterferon alfa-2a Increases Loss of Hepatitis B Surface Antigen in Patients with Chronic Hepatitis B
Background and aims
Patients chronically infected with the hepatitis B virus rarely achieve loss of serum hepatitis B surface
antigen (HBsAg) with the standard of care. We evaluated HBsAg loss in patients receiving the
combination of tenofovir disoproxil fumarate (TDF) and peginterferon alfa-2a (peginterferon), for a
finite duration, in a randomized trial
Methods
In an open-label, active-controlled study, 740 patients with chronic hepatitis B were randomly
assigned to receive TDF plus peginterferon for 48 weeks (group A), TDF plus peginterferon for 16
weeks followed by TDF for 32 weeks (group B), TDF for 120 weeks (group C), or peginterferon for
48 weeks (group D). The primary endpoint was the proportion of patients with serum HBsAg loss at
week 72.
Results
At week 72, 9.1% of subjects in group A had HBsAg loss, compared with 2.8% of subjects in group
B, none of the subjects in group C, and 2.8% of subjects in group D. A significantly higher proportion
of subjects in group A had HBsAg loss than in group C (P<.001) or group D (P=.003). However, the
proportions of subjects with HBsAg loss did not differ significantly between group B and group C
(P=.466) or group D (P=.883). HBsAg loss in group A occurred in hepatitis B e antigen-positive and -
negative patients with all major viral genotypes. The incidence of common adverse events (including
headache, alopecia, and pyrexia) and treatment discontinuation due to adverse events was similar
among groups.
Conclusion
A significantly greater proportion of patients receiving TDF plus peginterferon for 48 weeks had
HBsAg loss than those receiving TDF or peginterferon alone. ClinicalTrials.gov no: NCT01277601