Antiviral therapy of HBV- and HCV-induced liver cirrhosis.
Zavaglia. C C; Airoldi. A A; Pinzello. G G
Key Findings
- Interferon‑alpha is the primary drug used for HBV/HCV‑related cirrhosis
- Sustained virologic response in HCV cirrhosis with interferon alone is low (10‑15%)
- Combining ribavirin with interferon may improve response, but evidence is limited
Practical Outcomes
- There are no practical take‑aways for using thymosin‑alpha‑1 in this context. The abstract suggests sticking to established antiviral protocols and awaiting further clinical trials before considering new or experimental regimens.
Summary
The abstract reviews current antiviral treatments for liver cirrhosis caused by hepatitis B and C, focusing on interferon‑alpha, lamivudine, ribavirin and other drugs, and highlights that results are modest and more research is needed. It does not mention thymosin‑alpha‑1 or give any direct, actionable advice for self‑experimenters.
Abstract
Antiviral therapy is generally indicated in patients who have histologic evidence of chronic hepatitis and ongoing viral replication. The aim of treatment is to normalize alanine aminotransferase levels and to eliminate virus replication. Interferon-alfa (IFN-alpha) is the most used agent. The standard treatment regimen for hepatitis B e antigen (HBeAg)-positive cirrhosis is based on IFN-alpha given alone, but the efficacy of new antivirals (famciclovir, lamivudine) with or without IFN-alpha is currently under investigation. Conversely, the therapy of antiHBe-positive cirrhosis is far from being satisfactory. The results of treatment of patients affected by type C cirrhosis with IFN-alpha alone have been disappointing, as 10-15% of treated patients shows a sustained virologic response. Although current evidence suggests that the combination of ribavirin and IFN-alpha might be more efficacious than IFN alone in increasing the response rate in patients in the advanced fibrotic stage, the efficacy of this regimen for patients with well-compensated HCV-related cirrhosis is still unknown and prospective well-designed studies are urgently needed. Patients with decompensated cirrhosis are not generally treated unless they are included in liver transplantation programs. Prospective long-term trials with large sample sizes are needed to determine if responders to IFN-alpha have a low incidence of liver-related complications and hepatocellular carcinoma.
Study Information
pubmed
2000
2000-04-01T00:00:00.000Z
10.1097/00004836-200004000-00006
19
62