Side effects of therapy of hepatitis C and their management
Side effects of therapy of hepatitis C and their management
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DOI：
10.1053/jhep.2002.36810
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发表时间：
2002-11-01
期刊：
影响因子：
13.5
通讯作者：
Fried, MW
中科院分区：
文献类型：
--
作者：
Fried, MW
干扰素和利巴韦林联合治疗慢性丙型肝炎会产生许多众所周知的副作用，主要是疲劳、流感样症状、血液学异常和神经精神症状。与聚乙二醇干扰素（聚乙二醇干扰素α -2a和α -2b）联合治疗会产生与标准干扰素相似的不良事件，尽管某些不良事件的频率可能因制剂而异。在这些药物的注册试验中，10% - 14%的参与者需要因不良事件而过早退出治疗。大多数不良事件通过使用预先确定的标准减少剂量得到安全有效的管理。减量最常见的适应症是血液学异常，如贫血和中性粒细胞减少症，后者在聚乙二醇干扰素治疗组更常见。最近的数据表明，坚持规定的治疗方案可以增强抗病毒反应。最大化依从性的策略正在开发中，未来可能包括抑郁症的早期识别和治疗，以及选择性使用造血生长因子来改善血液学异常。
Interferon and ribavirin combination therapy for chronic hepatitis C produces a number of well-described side effects that are dominated by fatigue, influenza-like symptoms, hematologic abnormalities, and neuropsychiatric symptoms. Combination therapy with pegylated interferons (peginterferon alfa-2a and alfa-2b) yields an adverse event profile similar to standard interferon, although the frequency of certain adverse events may vary by preparation. Premature withdrawal from therapy due to adverse events was required in 10% to 14% of participants in registration trials of these agents. Most adverse events were safely and effectively managed by dose reduction using predetermined criteria. The most common indications for dose reduction were hematologic abnormalities, such as anemia and neutropenia, with the latter more frequent in peginterferon treatment arms. Recent data suggest that maintaining adherence to a prescribed treatment regimen can enhance antiviral response. Strategies to maximize adherence are being developed and, in the future, may include early identification of and therapy for depression and the selective use of hematopoietic growth factors to ameliorate hematologic abnormalities.