Combination therapy of low-dose of PegIFNa-2a and ribavirin for patients with HCV-infected decompensated cirrhosis.

Abstract

This study aims to evaluate the efficacy and tolerability of low-dose PEGylated interferon (PEG-IFN) a-2a combined with standard of care ribavirin (RBV). The therapy was administered to patients with chronic hepatitis C virus (HCV) with decompensated cirrhosis who underwent splenectomy or partial splenic artery embolization. A total of 106 patients with decompensated liver cirrhosis with chronic HCV infection were subjected to splenectomy (n = 89) or partial spleen artery embolization (n = 17) without the possibility of starting or continuing PEG-IFN and RBV because of neutropenia and/or thrombocytopenia. Antiviral treatment was started when the neutrocyte and platelet counts were increased and without severe surgical complications. A sustained virological response was obtained in 38 genotype 1 patients (59.3%) and 14 non-genotype 1 patients (56%) who underwent splenectomy and 6 genotype 1 patients (46.15%) and 3 non-genotype 1 patients (75%) who underwent partial splenic embolization. In the splenectomy group, the non-response rate of the genotype 1 patients was 28.13%, whereas that for non-genotype 1 patients was 24%. In the PSE group, the non-response rate among genotype 1 patients was 23.08%. All patients in the non-genotype 1 group obtained virological responses. The side effect was neutropenia. No patient died while on therapy. Both splenectomy and partial spleen artery embolization could be beneficial for low-dose PEG-IFNa-2a plus RBV antiviral therapy for early decompensated liver cirrhosis patients with chronic HCV infection and would not influence antiviral efficacy. However, patients should undergo complete follow-up.