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Treatment of Acute HCV Infection with Pegylated Interferon In a study conducted in Seattle, subjects with a positive anti-HCV test having tested negative with the past 12 months were treated with 6 months of pegylated interferon (pegIFN) monotherapy to determine the efficacy of this drug in acute HCV infection. The brand of pegIFN used in the study is not specified. Patients were recruited from a longitudinal study of HIV and HCV seronegative injection drug users (IDU) who are followed for 1 year to measure the incidence of HIV and HCV infections. Thirty IDU seroconverters were randomized to receive no treatment or to receive pegIFN for 6 months. The lag time between the diagnosis and the initiation of therapy is not clear Only 9 patients started pegIFN treatment (6 HCV-1 and 3 HCV-2/3), and 12 subjects remained untreated as controls (8 HCV-1 and 4 HCV-2/3). The treatment was concluded by 7 individuals, 6 of whom achieved sustained virological response (87%). Out of the 12 controls, only 2 cleared the virus (17%) spontaneously. During the study period, two serious adverse events occurred, both in the treatment arm (1 suicidal ideation and 1 death due to alcohol/heroin overdose). In addition, 3 of 21 (14%) subjects demonstrated reinfection with a different viral strain from the original infected strain. There
are missed pieces of information to interpret these data, but in line
with previous studies, they suggest that pegIFN is effective for the treatment
of acute HCV infection. Questions arise regarding the appropriateness
of treating IDU given the substantial losses and occurrence of reinfections
during treatment. 11/28/05 Reference |
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