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Hepatitis C Treatment in Patients With Porphyria Cutanea Tarda.

Abstract Hepatitis C virus (HCV) infection is a common susceptibility factor for porphyria cutanea tarda (PCT). Experience on HCV treatment in patients with PCT is limited. Recently, HCV treatment has improved with direct-acting antivirals (DAA). We review our experience on HCV treatment in patients with PCT with older and newer regimens.
PMID
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Authors

Mayor MeshTerms
Keywords

Direct-acting antivirals

Hepatitis C

Interferon

Porphyria

Journal Title the american journal of the medical sciences
Publication Year Start




PMID- 28641714
OWN - NLM
STAT- MEDLINE
DA  - 20170623
DCOM- 20170628
LR  - 20170628
IS  - 1538-2990 (Electronic)
IS  - 0002-9629 (Linking)
VI  - 353
IP  - 6
DP  - 2017 Jun
TI  - Hepatitis C Treatment in Patients With Porphyria Cutanea Tarda.
PG  - 523-528
LID - S0002-9629(17)30132-5 [pii]
LID - 10.1016/j.amjms.2017.03.007 [doi]
AB  - BACKGROUND: Hepatitis C virus (HCV) infection is a common susceptibility factor
      for porphyria cutanea tarda (PCT). Experience on HCV treatment in patients with
      PCT is limited. Recently, HCV treatment has improved with direct-acting
      antivirals (DAA). We review our experience on HCV treatment in patients with PCT 
      with older and newer regimens. MATERIALS AND METHODS: A retrospective chart
      review was conducted. HCV treatment was attempted 22 times in 13 patients with
      PCT (5 attempts in 1, 2 in 5 and 1 in the other 7 patients). RESULTS: Before
      starting HCV treatment, PCT was in complete remission in 16, partial remission in
      2, unknown status in 2 and active in 2 instances. PCT relapsed during therapy 6
      times (all interferon-based regimens and 2 including telaprevir), 4 requiring
      treatment interruption. Treatment was interrupted for reasons other than PCT
      relapse in 2 patients treated with interferon-based regimens. To prevent PCT
      recurrence, hydroxychloroquine was continued during HCV therapy 6 times (3
      interferon regimens, 2 ribavirin regimens without interferon and 1 DAA alone).
      Twelve patients achieved sustained viral response, 3 with interferon regimens and
      9 with DAA. Two patients with active PCT were treated with DAA, with reduction of
      plasma porphyrins in 1 and normalization in the other at the end of HCV therapy. 
      CONCLUSIONS: HCV treatment regimens including interferon or ribavirin may
      precipitate PCT relapse. Hydroxychloroquine may be useful to prevent such
      relapses. In this limited experience, DAA were not associated with PCT relapse.
      Studies are needed to examine DAA as a primary PCT treatment in HCV-infected
      patients.
CI  - Copyright (c) 2017 Southern Society for Clinical Investigation. Published by
      Elsevier Inc. All rights reserved.
FAU - Singal, Ashwani K
AU  - Singal AK
AD  - Division of Gastroenterology and Hepatology, The University of Alabama at
      Birmingham, Birmingham, Alabama. Electronic address: [email protected]
FAU - Venkata, Krishna V R
AU  - Venkata KVR
AD  - Department of Internal Medicine, The University of Alabama, Montgomery, Alabama.
FAU - Jampana, Sarat
AU  - Jampana S
AD  - Department of Internal Medicine, University of Texas Medical Branch, Galveston,
      Texas.
FAU - Islam, Fakhar-Ul
AU  - Islam FU
AD  - Division of Gastroenterology and Hepatology, The University of Alabama at
      Birmingham, Birmingham, Alabama.
FAU - Anderson, Karl E
AU  - Anderson KE
AD  - Department of Preventive Medicine and Community Health, University of Texas
      Medical Branch, Galveston, Texas; Department of Internal Medicine, University of 
      Texas Medical Branch, Galveston, Texas.
LA  - eng
GR  - U54 DK083909/DK/NIDDK NIH HHS/United States
PT  - Journal Article
DEP - 20170308
PL  - United States
TA  - Am J Med Sci
JT  - The American journal of the medical sciences
JID - 0370506
RN  - 0 (Antiviral Agents)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Antiviral Agents/*pharmacology/*therapeutic use
MH  - Female
MH  - Hepacivirus/*drug effects
MH  - Hepatitis C/complications/*drug therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Porphyria Cutanea Tarda/etiology
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Direct-acting antivirals
OT  - Hepatitis C
OT  - Interferon
OT  - Porphyria
EDAT- 2017/06/24 06:00
MHDA- 2017/06/29 06:00
CRDT- 2017/06/24 06:00
PHST- 2016/12/06 [received]
PHST- 2017/03/02 [revised]
PHST- 2017/03/03 [accepted]
AID - S0002-9629(17)30132-5 [pii]
AID - 10.1016/j.amjms.2017.03.007 [doi]
PST - ppublish
SO  - Am J Med Sci. 2017 Jun;353(6):523-528. doi: 10.1016/j.amjms.2017.03.007. Epub
      2017 Mar 8.