Treatment
of Acute Hepatitis C
By
Liz Highleyman  Past
studies have shown that treatment of acute hepatitis C virus (HCV) infection is
highly successful; a German study published in 2001, for example, found a sustained
virological response (SVR) rate of 98% using conventional
interferon monotherapy (Jaeckl 2001). However, many individuals with acute
infection will clear HCV spontaneously, so if therapy is started too soon, there
is a risk of treating patients who don't need it.
In
the May 2006 issue of Hepatology, researchers reported on a study looking
at the optimal duration of treatment for acute hepatitis C. The study initially
evaluated 161 patients, of whom 30 refused treatment and 29 experienced spontaneous
HCV
clearance. The remaining 102 patients with persistent HCV were randomly assigned
to 1.5 mcg weekly pegylated
interferon alpha-2b (Peg-Intron) monotherapy for 8, 12, or 24 weeks. Conclusion The
authors concluded that pegylated
interferon monotherapy "effectively induces high sustained virologic
response rates in patients with acute hepatitis C virus infection, thus preventing
development of chronic hepatitis C." They suggested that treatment duration
should be further optimized based on genotype
and rapid virological response at week 4. Treating
Acute HCV in Prison  The
Hepatology study, and another
recent study of HIV/HCV coinfected patients reported in the May 12, 2006 issue
of AIDS, demonstrate that treatment of acute hepatitis C can be effective.
However, many people with acute HCV infection do not experience symptoms, and
most cases of hepatitis C are not identified at this stage.
A
study reported in the June 15 issue of Clinical Infectious Diseases suggests
that prisons and drug detoxification and treatment center may be appropriate settings
for detecting and treating acute HCV infection among injection drug users. In
this study, on-site medical providers at prisons and detox facilities were educated
about risk factors for and symptoms of hepatitis, and asked to refer all potential
cases to a specialty clinic. Conclusion The
authors concluded that, "Incarceration presents a unique opportunity to identify
injection drug users with acute HCV infection, to initiate counseling regarding
other blood-borne pathogens, and to facilitate immunizations and HCV treatment." 6/20/06 References
SM
Kamal, KN Moustafa, J Chen, and others. Duration of peginterferon therapy in acute
hepatitis C: a randomized trial. Hepatology. 43(5): 923-931. May 2006.
BH
McGovern, A Wurcel, AY Kim, and others. Acute hepatitis C virus infection in incarcerated
injection drug users. Clin Infect Dis. 42(12): 1663-1670. June 15, 2006.
E
Jaeckel, M Cornberg, H. Wedemeyer, and others. Treatment of acute hepatitis C
with interferon Alfa-2b. New England J Med. 345: 1452-1457. November 15,
2001.
| |
Using an intent-to-treat analysis, 67.6% patients who received treatment for 8
weeks achieved SVR; the rate was 82.4% after 12 weeks and 91.2% after 24 weeks.