Ribavirin and interferon is effective for hepatitis C virus clearance in hepatitis B and C dually infected patients

Authors

  • Chun-Jen Liu,

    1. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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  • Pei-Jer Chen,

    1. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    2. Graduate Institute of Clinical Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    3. Hepatitis Research Center, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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  • Ming-Yang Lai,

    1. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    2. Graduate Institute of Clinical Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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  • Jia-Horng Kao,

    1. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    2. Graduate Institute of Clinical Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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  • Yung-Ming Jeng,

    1. Department of Pathology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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  • Ding-Shinn Chen 1 Chang-Te St.

    Corresponding author
    1. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    2. Graduate Institute of Clinical Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
    • Taipei 100, Taiwan; fax: (886) 2-23224793
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Abstract

Ribavirin and interferon (IFN) are an effective treatment in 30% to 60% of patients with chronic hepatitis C. Whether they are also effective in dually infected patients with hepatitis B and C is unknown. Twenty-four patients with chronic hepatitis seropositive for both hepatitis B surface antigen and antibody to HCV received ribavirin 1,200 mg daily for 6 months, together with 6 million units (MU) IFN-α 2a thrice weekly for 12 weeks and then 3 MU for another 12 weeks. Serum HCV RNA was positive in 21 patients (group I, serum HBV DNA positive in 17 patients) and negative in 3 patients (group II, all HBV DNA positive) by Amplicor (Cobas Amplicor Monitor, Roche Diagnostics, Branchburg, NJ). Serum alanine aminotransferase (ALT), HCV RNA, and hepatitis B virus (HBV) DNA were monitored regularly for 12 months. Another 30 patients with chronic hepatitis C alone receiving the same regimen, served as controls. The serum HCV clearance rate in group I patients (43%) was comparable with that in controls (60%, P = .63) 24 weeks posttreatment. The serum ALT normalization rate in group I and group II patients was 43% and 0%, respectively, 24 weeks posttreatment. After treatment, resurgence of HBV and HCV was encountered in 4 group I patients and 1 group II patient, respectively. In conclusion, in hepatitis B and C dually infected patients, combination of IFN with ribavirin can achieve a sustained HCV clearance rate comparable with hepatitis C alone. In dually infected patients, the treatment may alter the dominant, ruling hepatitis virus.

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