Peginterferon alfa-2a and Ribavirin in Patients with Chronic Hepatitis C and Inherited Bleeding Disorders

Abstract

Background: Patients with inherited bleeding disorders who regularly receive clotting factors are frequently infected with hepatitis C virus (HCV). Liver biopsy in these patients is high-risk and not always performed. There is no report on pegylated interferon (PEG-IFN) and ribavirin in patients with bleeding disorders in whom no histologic data is available. Aim: To assess the safety and efficacy of combined PEG-IFN alfa-2a and ribavirin in patients with inherited bleeding disorders and hepatitis C. Methods: We studied 37 patients with inherited bleeding disorders and HCV infection. Patients where planned to receive pegylated interferon alfa 2a (PEG-IFN alfa-2a) 180micg weekly and ribavirin 800mg daily for 48 weeks. They were then followed for 24 weeks after the end of treatment. Results: Early virologic response at week 12 of treatment was achieved in 31/34 patients (91%) and end-of-treatment response was achieved in 30/31 patients (97%). Sustained virologic response was 26/32 (81%) and 26/35 (74%) on per-protocol and intention-to-treat analysis respectively. Dose reduction due to adverse effects was necessary in 11 patients. Conclusion: The combination of PEG-IFN alpha 2a and ribavirin is safe and highly effective in patients with inherited bleeding disorders and HCV infection, even when histologic data is absent.