Efficacy of cumulative dose of polyethylene glycol-interferon α-2a combined with ribavirin in patients with decompensated hepatitis C virus-related liver cirrhosis

Abstract

Objective To observe the efficacy of cumulative dose of polyethylene glycol-interferon (Peg-IFN)α-2a combined with ribavirin in patients with decompensated hepatitis C virus (HCV)-related liver cirrhosis, and to evaluate the effects of anti-virus therapy on the progress of the disease. Methods From January 2005 to March 2009, patients with decompensated HCV-related liver cirrhosis were enrolled, also included patients received partial splenic embolization. Peg-IFNα-2a combined with ribavirin therapy was given to patients whose blood cell met interferon (IFN) therapy standards. The dosage of Peg-IFNα-2a and ribavirin was adjusted according to the tolerance of the patients. After the treatment, the patients were followed-up for 24 weeks. The patients whose blood cell did not meet IFN therapy standards and the patients unwilling to receive anti-virus therapy were assigned to control group and were followed-up for 96 weeks. The total amount of medication was calculated according to cumulative exposure dose. Sustained virological response (SVR), recurrence rate, liver function and disease progression were observed. The t test or Chi-square test was performed for comparison between groups and rate of disease progression was analyzed with Kaplan Meier curve. Results After anti-virus therapy, SVRs of patients with cumulative dose of Peg-IFNα-2a and ribavirin over 60% (include 60%) were 27.3%(12/44) and 27.7%(13/47), respectively; the recurrence rates were 7/19 and 35.0%(7/20), respectively. In patients with cumulative dose less than 60%, SVRs were 1/7 and 1/4, respectively, and the recurrence rates were both 1/2; the differences of different doses was not statistically significant (all P>0.05). At the 24th week of follow-up after therapy, the Child-Pugh score of combined therapy group was 7.9±1.4, which was lower than that before treatment (8.5±1.2), and the difference was statistically significant (t=2.33, P=0.02). At the 96th week of follow-up, the Child-Pugh score of control group was 10.0±1.6, which was higher than that before treatment (8.5±1.4), and the difference was statistically significant (t=5.82, P<0.01). The disease progression rate of combined therapy group was 15.7%, which was lower than that of control group (32.4%), and the difference was statistically significant (χ2=4.34, P=0.04). Conclusion The application of non-standard dosage of Peg-IFNα-2a combined with ribavirin in the patients with decompensated HCV-related liver cirrhosis can achieve virological response once the cumulative dose reached certain standards, improve Child-Pugh scores of patients and slow disease progression. Key words: Peg-IFNα-2a; Hepatitis C; Decompensated liver cirrhosis; Cumulative dose