Chronic hepatitis C treatment outcome in Somdejpraputhayodfajulaloak Maharaj Fort Hospital from 2007 to 2014
Abstract
Liver cancer is a leading cause of death in Thailand especially in North Eastern that known high prevalence rate of hepatitis C infection. The results of hepatitis C infection are chronic hepatitis, cirrhosis and liver cancer. The treatments for hepatitis C (HCV) lead to resolved viral infection and therefore significantly reduce the likelihood of cirrhosis and liver cancer. However, the treatments for HCV are provided only in university hospital or large hospital settings whereas for remote community patients, treatments can be inaccessible. Therefore, Somdet Phraphutthayodfah Chulalok (King Rama 1) Hospital established a HCV infection treatment clinic to provide better access to care for neighborhoods. The physicians and staff have been trained in the hepatitis care unit from Srinagarind Hospital according to Thailand Practice Guideline for Management of Chronic Hepatitis B and C in 2011(2012 revision, Liver Disease Association of Thailand).
The purpose of this study was to determine the efficacy and safety of the combination of Peg interferon Alpha-2a and Ribavirin for the treatment of 18 patients with chronic HCV infection (genotype1, 2 and 3). The patients were followed up after treatment for at least 18 months. The descriptive research method was used in the study. The retrospective reviewed the medical records of 18 patients who had HCV infection at Somdet Phraphutthayodfah Chulalok (King Rama 1) Hospital from January, 2007 to December, 2014. Data analysis was conducted using descriptive statistics such as percentage, mean, and standard.
The study showed that the virus was not detected from a blood test after treatment and following 24 months (Sustained Virological Response: SVR24) in 16patients (84%). A serious complication during treatment did not occur.
It was concluded from this study that the HCV infection treatments were effective and safe for patients who were treated in the clinics by physicians and staff that were trained in the hepatitis care unit according to the treatment guideline of Liver Disease Association of Thailand.
References
Davis GL, Albright JE, Cook SF, Rosenberg DM. Projectiong future complications of chronic hepatitis C in the united States. Liver Transpl 2003;9:331-8
Tanwandee T, Piratvisuth T, Phornphutkul K, Mairiang P, Permpikul P, Poovorawan Y. Disk factors of hepatitis C virus infection in blood dorners in Thailand: a multicenter case-control study. J Med Assoc Thai 2006;89 Suppl5:s79-83
Kiyosawa K, Sodeyama T Tanaka E,GiboY, Yoshizawa K, Nakano Y, et al. Interrelationship of blood transfusion, non-A, non-B hepatitis and hepatocellular carcinoma analysis by detecton of antibody to hepaitits C virus Hepatology 1990;12:671-5
Tong MJ, el-Farra NS, Reikes AR, CoRL. Clinical outcomes after transfusion-association hepatitis C. N Engl J Med 1995;332:1463-6
Tanwandee T, Chinuvati T. The natural history of chronic hepatitis C infection in Thai patrent. J Gastroenterol Hepatol 1999;14 Suppl:s96
Poynard T, Bedossa P, Opolon P. Natural history of liver fibrosis progression in patients with chronic hepatitis. The OBSVIRC, METAVIR, CLINIVIR, and DOSVIRC groups. Lancet 1997;349:825-32
Fattovich G, Giustina G, Gegos F, Tremolada F, Diodati G, Almasio P, et al. Morbidity and mortality in compensated cirrhosis type C: a retrospective follow-up study of 384 patients. Gastroenterlogy 1997;112:463-72
Serfaty L, Aumaitre H, Chazouilleres O, Bonnand AM, Rosmorduc O, Poupon RE. et al. Determinants of out-come of compensated hepatitis C virus-related cirrhosis. Hepatology 1998;27:1435-40
Ghany MG, Strader DB, Thomas DL, Seeff LB. Diagnosis, management, and treatment of hepatitis C: and update. Hepatology 2009;49:1335-74
Fried MW, Shiffman ML, Reddy KR, et al. Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 2002;347:975-82
Hadziyannis SJ, Sette H Jr, Morgan TR, et al. Peginterferon-alpha2a and ribavirin combination therapy in chronic hepatitis C: a randomized study of treatment duration and ribavirin dose. Ann Intern Med 2004;140:346-55
Manns MP, McHutchison JG, Gordon SC, et al. Peginterferon alfa-2a plus ribavirin compared wih interferon afa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomized trial. Lancet 2001;358:958-65
Foster GR,Fried MW, Hadziyannis SJ, Messinger D, FreivogelK, Weiland O. Prediction of sustained virological response in chronic hepatitis C patients treated with Peginterferon afa-2a (40KD) and ribavirin. ScndJ Gastroenterol 2007;42:247-55
Harrison SA, Rossaro L, Hu KQ, et al. Serum cholesterol and statin use predict virological responseto Peginterferon and ribavirin therapy. Hepatology 2010;52:864-74
Ferenci P. Predictors of response to therapy for chronic hepatitis C. semin Liver Dis 2004;Suppl 2:25-31
Yuen MF, Hou JL, Chutputti A, Hepatocellular carcinoma in the Asia pacific region. J Gastroenterol Hepatol 2009; 24:346-53
Sanjeev A. et.al : New England Journal of Internal Medicine: Outcome of treatment for Hepatitis C Virus Infection by Primary Care Provider. NEJM 2011;364:2199-207
Chronic Hepatitis C Infection: New England Journal of Internal Medicine: Chronic Hepatitis C Infection 2011;364:2429-38.
Maribel R. et.al: Peginterferon alfa-2a and Ribavirin in Latino and Non-Latino Whites with Hepatitis C: New England Journal of Internal Medicine 2009;360:257-67
Downloads
Published
How to Cite
Issue
Section
License
วารสารนี้เป็นลิขสิทธิ์ของโรงพยาบาลมหาสารคาม
