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2016 ; 11
(3
): e0150299
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Triple Therapy with First Generation Protease Inhibitors for Hepatitis C Markedly
Impairs Function of Neutrophil Granulocytes
#MMPMID26938078
Spindelboeck W
; Horvath A
; Tawdrous M
; Schmerböck B
; Zettel G
; Posch A
; Streit A
; Jurse P
; Lemesch S
; Horn M
; Wuensch G
; Stiegler P
; Stauber RE
; Leber B
; Stadlbauer V
PLoS One
2016[]; 11
(3
): e0150299
PMID26938078
show ga
First-generation HCV protease inhibitors represent a milestone in antiviral
therapy for chronic hepatitis C infection (CHC), but substantially increased
rates of viral clearance are offset by increased rates of infection and
infection-associated deaths, especially of patients with advanced liver disease.
We aimed to assess whether first generation protease inhibitors interfere with
neutrophil function. We included 108 consecutive, retrospective CHC patients and
44 consecutive, prospective CHC patients who were treated with peginterferon and
ribavirin with or without protease inhibitors according to the guidelines in the
period of November 2012 to June 2015. 33 healthy volunteers served as controls.
Infection data were evaluated in all patients. Neutrophil phagocytosis, oxidative
burst, elastase and diamine oxidase levels during 12 weeks of triple (n = 23) or
dual therapy (n = 21) were studied in the prospective part. In the retro- and
prospective cohorts patients experiencing clinically relevant infections were
significantly more frequent during protease inhibitor therapy (31% and 26%) than
during therapy with peginterferon and ribavirin (13% and 0%). Neutrophil
phagocytosis decreased to 40% of baseline with addition of protease inhibitors to
P/R but recovered 6 months after end of treatment. Protease inhibitors also
seemed to reduce serum elastase levels but did not impact on gut permeability.
Impaired neutrophil function during triple therapy with first generation HCV
protease inhibitors may explain the high infection rate associated to these
treatments and be of relevance for treatment success and patient survival.
|Adult
[MESH]
|Antiviral Agents/pharmacology/*therapeutic use
[MESH]