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Patients in Italy Respond Well to Hepatitis C Treatment

Italian researchers recently published a small study involving the use of pegylated interferon (Peg-IFN) and ribavirin (Rbv) in hemophilia patients co-infected with the hepatitis C virus (HCV) and the human immunodeficiency virus (HIV). The lead investigator of the study was Dr. Maria Elisa Mancuso, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, IRCCS Maggiore Hospital, Mangiagalli and Regina Elena Foundation, Milan, Italy.


HCV can cause liver cancer, cirrhosis, end-stage liver disease and liver failure. Although Peg-IFN/ Rbv is the standard treatment for patients with chronic HCV, nearly 50% do not respond. Patients who do respond to treatment often experience debilitating side effects that can last the duration of the treatment—either 24 or 48 weeks.


The progression to end-stage liver disease can be accelerated in co-infected patients, causing a challenge to standard treatments. The purpose of the study was to measure the safety and efficacy of Peg-IFN/ Rbv combination therapy in this difficult-to-treat patient population.


Participating in the multicenter study were 34 adult, co-infected hemophilia patients. Each patient received weekly injections of Peg-IFN and orally administered Rbv. All but one of the patients completed the study, which lasted 48 weeks. In all, 15 (44%) achieved a “sustained virological response” (SVR), which indicates undetectable HCV levels for 6 months after completion of therapy. Though not technically a cure – the HCV is often not completely eradicated from the liver – SVR is still the goal for clinicians because suppressing the virus indefinitely to undetectable levels decreases the disease’s harmful effects. Follow-up tests, conducted three years after the study ended, showed that the SVR patients were producing increased CD4 and CD8 white blood cell counts. CD4 and CD8 are vital cells to the body’s immune response, considered key indicators of a healthy immune system.  


“These results strongly encourage anti-HCV therapy in HCV/HIV co-infected hemophiliacs,” concluded the authors.


The study, “HCV/HIV Co-infection in Hemophiliacs: High Rates of Sustained Virological Response to Pegylated Interferon and Ribavirin Therapy,” was published online October 3, 2009 by the Journal of Thrombosis and Haemostasis.




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