giovedì, 23 maggio 2024
21 Febbraio 2001


Available from March – PEG Interferon; a new weapon against infection

Hepatitis C infects in an insidious way; a silent killer, it enters the bloodstream and can remain inactive for 10-20 years. The majority of cases who host the virus become aware
solely by chance. It manifests itself spontaneously normally when the patient is already compromised, the disease already in its acute phase.
“HCV”, explains Alfredo Alberti, Associate Professor of the Department of Medical and Clinical Experimentation at the University of Padova, “is a small RNA virus which
mutates constantly under the pressure of the immune system of the host, so avoiding control by antibodies. This characteristic besides being responsible for the enormous difficulties encountered so far in research to develop an effective vaccine, makes Hepatitis C a world health emergency, the most frequent cause of chronic liver disease,
of cirrhosis and of hepatocarcinoma, conditions that every year in Italy kill 30 thousand people.
“Chronic Hepatitis C”, adds prof. Alberti, “is a progressive illness. Cirrhosis develops subtely in 10-30 years and the risk and the speed of progression of Cirrhosis are influenced by the genetic factors of the host, the age of the host at the moment of infection, the use of alcohol and the presence of coinfection with other hepatitis viruses or HIV. When the infection has reached the cirrhotic stage it can remain in balance for some years before emerging as hepatocarcinoma or arterial hypertension which causes serious digestive haemorrhage or lack of hepatic balance. These complications manifest
annually in 2-5% of patients with an incidence that augments gradually with the duration of the cirrhosis.”
“The introduction of PEG Interferon”, maintains Prof. Mauro Rizzetto, Head of the Department of Systemic Digestive Illnesses of the Molinette Hospital of Turin,
“not only represents an improvement in therapeutic performance but also substantial practical advantages for the patient. While the effect of conventional Interferon is exhausted in a short time, so that the dose must be repeated every two days,
the pegylated formula provides a slow release of the cytokine which maintains a pharmacological dose valid for circa one week. With these different kinetics “ adds Prof. Rizzetto, “there are results with PEG Interferon monotherapy similar to those obtained with traditional combination therapy (high response in 40% of cases). If, however, you evaluate the results by viral genotype the high response begins at circa 30-35% of patients of genotype 1 ending at 70% of those with genotypes 2 and 3. The weekly dose compared with the thrice weekly dose is also more convenient for the patient and has fewer side–effects such as fever, myalgia and influenza-like symptoms.”
It is precisely the mode of administration that represents an enormous advantage for sufferers with a consequent net gain in their quality of life.
“If it is true that during the first phase of treatment there is a symptomology (fever, general weakness, poor general health) that temporarily affects physical performance” affirms Antonio Craxì, Gastroenterology Lecturer at The University of Palermo, “ then a once weekly administration overcomes this effect and the patient in antiviral treatment will be well, can engage in normal social and sexual relations and in conclusion doesn’t have particular problems. It is also extraordinarily important” adds Craxì,”that the positive effects of the outcome of the therapy are demonstrated with objective systems, with psychometric scales for the measurement of performance.
The patient who is free from chronic infection gains points in these tests much higher than those achieved prior to commencing treatment, when he was in a phase which was asymptomatic but which was perceived as illness.”
PEG Interferon also opens other interesting therapeutic prospectives. “In Europe and in Canada”, says Massimo Colombo, Director of the Chair of Gastroenterology at Milano University, “they are beginning a multicenter study to evaluate prolonged treatment with PEG Interferon and the capacity to arrest fibrosis in patients with hepatitis C who have not seen elimination of the viral infection with traditional combined therapy.
Another potential use of PEG Interferon is the long-term treatment of patients with virus C cirrhosis who do not respond to traditional combined therapy. The aim of this treatment is to prevent clinical inbalance such as jaundice, encephalopathy and digestive
haemorrhage or the development of hepatic tumour”.