Hepatitis C Management

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Question:

I use nitazoxanide (Alinia) for multiple gastrointestinal infections in my pediatric patients. I am hearing that it may also treat hepatitis C. Is this true? How is it used?

Clinical trials using nitazoxanide in combination with PEG-IFN and ribavirin in genotype 4 patients in Egypt have shown promising results. Because of this, genotype 1 clinical trials are underway in the United States and in Europe. Data presented at EASL in 2008 showed the group receiving triple therapy (nitazoxanide-PEG-RBV) compared with the standard of care group had higher SVR (79% vs 50%) and RVR (64% vs 38%) rates. It appears treatment will involve a lead-in phase with nitazoxanide (likely 4 weeks) and then the PEG/RBV will be added. Nitazoxanide dosing is 500 mg PO BID.

Because you have been using nitazoxanide in pediatric patients, you know it is well tolerated. Currently, it is indicated for the treatment of cryptosporidium and giardia in children. Its antiviral activity was discovered somewhat accidentally, and there is hope for its use in the future.

For more information, see the section on hepatitis C in Children in the Hepatitis C Management monograph.

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