Peginterferon alfa-2a and Ribavirin in Patients with Chronic Hepatitis C and Inherited Bleeding Disorders

Patients with inherited bleeding disorders who regularly receive clotting factors are frequently infected with hepatitis C virus (HCV). Liver biopsy in these patients is high-risk and not always performed. There is no report on pegylated interferon (PEG-IFN) and ribavirin in patients with bleeding disorders in whom no histologic data is available. To assess the safety and efficacy of combined PEG-IFN alfa-2a and ribavirin in patients with inherited bleeding disorders and hepatitis C. We studied 37 patients with inherited bleeding disorders and HCV infection. Patients where planned to receive pegylated interferon alfa 2a (PEG-IFN alfa-2a) 180micg weekly and ribavirin 800mg daily for 48 weeks. They were then followed for 24 weeks after the end of treatment. Early virologic response at week 12 of treatment was achieved in 31/34 patients (91%) and end-of-treatment response was achieved in 30/31 patients (97%). Sustained virologic response was 26/32 (81%) and 26/35 (74%) on per-protocol and intention-to-treat analysis respectively. Dose reduction due to adverse effects was necessary in 11 patients. The combination of PEG-IFN alpha 2a and ribavirin is safe and highly effective in patients with inherited bleeding disorders and HCV infection, even when histologic data is absent.