A Comparison between Pegylated Interferon Alpha-2a and Standard Interferon in Combination with Ribavirin in Treating Patients with Bleeding Disorders and Chronic Hepatitis C

Patients with bleeding disorders are frequently infected with hepatitis C virus (HCV). There are few reports on the effect of standard interferon in these patients and no published report on pegylated interferon. The aim of this study was to compare pegylated interferon alpha-2a and standard interferon alpha with ribavirin in patients with bleeding disorders and chronic HCV infection. Consecutive patients referring to a specialized clinic in Tehran were included in the study. The first 37 patients received pegylated interferon (PEGASYS, Hoffmann-La Roche Inc., Basel, Switzerland), 180 μg weekly and the next 38 patients received standard interferon, 3 million units 3 times a week. Both groups also received ribavirin 800 mg daily. Patients were treated for 48 weeks and were followed for 24 weeks. Liver biopsy was not performed due to the potential risks involved in patients with bleeding disorders. 34 patients in each group completed the study. The intention-to-treat sustained viral response was 34% and 62% in the standard interferon and pegylated interferon group, respectively (p=0.02). Pegylated interferon alpha-2a and ribavirin is almost twice as effective as standard interferon and ribavirin in treating HCV infection in patients with bleeding disorders and is an acceptable treatment option even when histologic data is not available.