Gastroenterology
Volume 136, Issue 3 , Pages 856-862 , March 2009

Improved Virologic Response in Chronic Hepatitis C Genotype 4 Treated With Nitazoxanide, Peginterferon, and Ribavirin

  • Jean–François Rossignol

      Affiliations

    • The Romark Institute for Medical Research, Tampa, Florida
    • Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Stanford, California
    • ,
  • Asem Elfert

      Affiliations

    • Department of Gastroenterology and Hepatology, University of Tanta, Faculty of Medicine, Tanta, Egypt
    • ,
  • Yehia El–Gohary

      Affiliations

    • Department of Tropical Medicine and Infectious Diseases, University of Alexandria, Faculty of Medicine, Alexandria, Egypt
    • ,
  • Emmet B. Keeffe

      Affiliations

    • The Romark Institute for Medical Research, Tampa, Florida
    • Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Stanford, California
    • Corresponding Author InformationReprint requests Address requests for reprints to: Emmet B. Keeffe, MD, Romark Laboratories, L.C., 2320 Marinship Way, Suite 250, Sausalito, California 94965. fax: (415) 332-1067

Received 29 August 2008 ,Accepted 13 November 2008.

References 

  1. World Health Organization. Hepatitis C (Fact sheet number 164, revised October 2000). http://www.who.int/mediacentre/factsheets/fs164/enAccessed: May 2, 2008
  2. Anderson VR, Curran MP. Nitazoxanide: a review of its use in the treatment of gastrointestinal infections. Drugs. 2007;67:1947–1967
  3. Korba BE, Montero AB, Farrar K, et al. Nitazoxanide, tizoxanide and other thiazolides are potent inhibitors of hepatitis B virus and hepatitis C virus replication. Antiviral Res. 2008;77:56–63
  4. Elazar M, Liu M, McKenna S, et al. Nitazoxanide (NTZ) is an inducer of eIF2a and PKR phosphorylation. (abstr) Hepatology. 2008;48:1151A
  5. Rossignol JF, Kabil SM, El-Gohary Y, et al. Clinical trial: randomized, double-blind, placebo-controlled study of nitazoxanide monotherapy for the treatment of patients with chronic hepatitis C genotype 4. Aliment Pharmacol Ther. 2008;28:574–580
  6. AIDS Clinical Trials Group. AIDS Clinical Trials Group (ACTG) toxicity grading scale. Silver Spring, MD: AIDS Clinical Trials Group; 1996;
  7. Knodell RG, Ishak KJ, Black WC, et al. Formulation and application of a numerical scoring system for assessing histological activity in asymptomatic chronic active hepatitis. Hepatology. 1981;1:431–435
  8. Goodman ZK, Ishak JG. Histopathology of hepatitis C virus infection. Semin Liver Dis. 1995;15:71–81
  9. Egyptian Ministry of Health. Annual report: 2007. http://www.mohp.gov.eg/mainAccessed: May 2, 2008
  10. Kamal SM, Nasser IA. Hepatitis C genotype 4: what we know and what we don't yet know. Hepatology. 2008;47:1371–1383
  11. Legrand-Abravanel F, Nicot F, Boulestin A, et al. Pegylated interferon and ribavirin therapy for chronic hepatitis C virus genotype 4 infection. J Med Virol. 2005;77:66–69
  12. Rossignol JF, Elfert A, Keeffe EB. Evaluation of a 4 week lead-in phase with nitazoxanide (NTZ) prior to peginterferon (PegIFN) plus NTZ for treatment of chronic hepatitis C: final report. (abstr) Hepatology. 2008;48:344A–345A
  13. Rossignol JF, Elfert A, El-Gohary Y, et al. Randomized controlled trial of nitazoxanide-peginterferon-ribavirin, nitazoxanide-peginterferon and peginterferon-ribavirin in the treatment of patients with chronic hepatitis C genotype 4. (abstr) J Hepatol. 2008;48(Suppl 2):S30
  14. Hoffman PS, Sission G, Croxen MA, et al. Antiparasitic drug nitazoxanide inhibits the pyruvate oxidoreductases of Helicobacter pylori, selected anaerobic bacteria and parasites and Campylobacter jejuni. Antimicrob Agents Chemother. 2007;51:868–876
  15. Korba BE, Elazar M, Lui P, et al. Potential for hepatitis C virus resistance to nitazoxanide or tizoxanide. Antimicrob Agents Chemother. 2008;52:4069–4071

 Conflicts of interest The authors disclose the following: Drs Rossignol and Keeffe are employees of Romark Laboratories, L.C., and participated in the design and conduct of this study, data analysis, and creation of this manuscript. Drs Asem Elfert and Yehia El-Gohary received research grant support from Romark Laboratories, L.C., for the conduct of this study and collection of data. This manuscript was written by the authors without independent contract writing assistance.

PII: S0016-5085(08)02051-9

doi: 10.1053/j.gastro.2008.11.037

Gastroenterology
Volume 136, Issue 3 , Pages 856-862 , March 2009

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