Maria-Carlota Londoño1, Christie Perelló2, Joaquín Cabezas3, Nuria Cañete4, Sabela Lens5, Zoe Mariño5, Martina Gambato5, Raquel Rodríguez2, Susana Menéndez3, José A Carrión4, Javier Crespo3, José Luis Calleja2, Xavier Forns5. 1. Liver Unit, Hospital Clínic Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain. Electronic address: mlondono@clinic.ub.es. 2. Gastroenterology and Hepatology Service, Hospital Universitario de Puerta de Hierro-Majadahonda, IDIPHIM, CIBERehd, Madrid, Spain. 3. Department of Digestive Diseases, Hospital Universitario Marqués de Valdecilla and Marqués de Valdecilla Research Institute (IDIVAL), Santander, Spain. 4. Liver Section, Gastroenterology Department, Hospital del Mar, Universitat Autònoma de Barcelona, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain. 5. Liver Unit, Hospital Clínic Barcelona, IDIBAPS, CIBERehd, Barcelona, Spain.
Abstract
BACKGROUND & AIMS: Antiviral therapy with interferon and ribavirin (double therapy) is associated with a significant risk of developing bacterial infections in patients with hepatitis C-related cirrhosis. The addition of telaprevir or boceprevir seems to increase this risk but there are no studies yet to compare the infection rate between both treatments. We aimed to assess rate, type and predictive factors of infection in cirrhotic patients undergoing triple or double antiviral therapy. METHODS: This was a retrospective analysis of prospectively collected data. 167 patients with hepatitis C-related cirrhosis undergoing triple therapy (cohort A) and 81 receiving double therapy (cohort B) were enrolled in the study. Only Child-Pugh A patients were included. RESULTS: The infection rate was significantly higher for patients in cohort A as compared to those in cohort B (25% vs. 9%, p=0.001). Interestingly, respiratory tract infections were significantly more frequent in patients in cohort A (12% vs. 1%; p=0.049). The use of triple antiviral therapy was the only predictive factor of infection. Severe infections were also more frequent in patients in cohort A, but the difference did not reach the level of significance (13% vs. 6%, p=0.123). CONCLUSIONS: Triple therapy carries a higher risk of infections in patients with cirrhosis and changes the pattern of infection in this subpopulation. Further studies are needed in order to establish the underlying mechanism of this event.
BACKGROUND & AIMS: Antiviral therapy with interferon and ribavirin (double therapy) is associated with a significant risk of developing bacterial infections in patients with hepatitis C-related cirrhosis. The addition of telaprevir or boceprevir seems to increase this risk but there are no studies yet to compare the infection rate between both treatments. We aimed to assess rate, type and predictive factors of infection in cirrhotic patients undergoing triple or double antiviral therapy. METHODS: This was a retrospective analysis of prospectively collected data. 167 patients with hepatitis C-related cirrhosis undergoing triple therapy (cohort A) and 81 receiving double therapy (cohort B) were enrolled in the study. Only Child-Pugh A patients were included. RESULTS: The infection rate was significantly higher for patients in cohort A as compared to those in cohort B (25% vs. 9%, p=0.001). Interestingly, respiratory tract infections were significantly more frequent in patients in cohort A (12% vs. 1%; p=0.049). The use of triple antiviral therapy was the only predictive factor of infection. Severe infections were also more frequent in patients in cohort A, but the difference did not reach the level of significance (13% vs. 6%, p=0.123). CONCLUSIONS: Triple therapy carries a higher risk of infections in patients with cirrhosis and changes the pattern of infection in this subpopulation. Further studies are needed in order to establish the underlying mechanism of this event.
Authors: Neal Patel; Kian Bichoupan; Lawrence Ku; Rachana Yalamanchili; Alyson Harty; Donald Gardenier; Michel Ng; David Motamed; Viktoriya Khaitova; Nancy Bach; Charissa Chang; Priya Grewal; Meena Bansal; Ritu Agarwal; Lawrence Liu; Gene Im; Jennifer Leong; Leona Kim-Schluger; Joseph Odin; Jawad Ahmad; Scott Friedman; Douglas Dieterich; Thomas Schiano; Ponni Perumalswami; Andrea Branch Journal: World J Gastroenterol Date: 2016-03-07 Impact factor: 5.742
Authors: Walter Spindelboeck; Angela Horvath; Monika Tawdrous; Bianca Schmerböck; Gabriele Zettel; Andreas Posch; Andrea Streit; Petra Jurse; Sandra Lemesch; Martin Horn; Gerit Wuensch; Philipp Stiegler; Rudolf E Stauber; Bettina Leber; Vanessa Stadlbauer Journal: PLoS One Date: 2016-03-03 Impact factor: 3.240