Optimizing the Dose and Duration of Therapy for ChronicHepatitis C .
- Author:
Nipaporn PICHETSHOTE
1
;
Erik GROESSL
;
Helen YEE
;
Samuel B HO
Author Information
1. Department of Medicine, Health Services Research and Development, VA San Diego Healthcare System, and University of California, San Diego, CA and Hepatitis C Resource Center, VA Medical Center, San Francisco, CA, USA. Samuel.Ho2@va.gov
- Publication Type:Review
- Keywords:
Hepatitis C;
Peginterferon alfa;
Interferon;
Ribavirin
- MeSH:
Fibrosis;
Genotype;
Hepatitis C;
Humans;
Interferon-alpha;
Interferons;
Retreatment;
Ribavirin;
Viral Load
- From:Gut and Liver
2009;3(1):1-13
- CountryRepublic of Korea
- Language:English
-
Abstract:
Recent studies indicate that antiviral treatment with pegylated interferon alfa and ribavirin for hepatitis C can be individualized based on viral and host characteristics and the pattern of virologic response during the initial months of antiviral treatment. Patients with a low initial viral load who demonstrate a rapid virologic response to antiviral therapy may be treated with a shorter duration of therapy and are less sensitive to reduced dosing of ribavirin. Patients with delayed virologic response will require a longer duration of therapy - up to 72 weeks for patients with genotype 1 - in order to optimize chances of a sustained virologic response. Patients who were nonresponders or relapsed after an acceptable course of antiviral therapy may be retreated using a more intensive regimen and/or a longer duration of therapy. Previous nonresponders to pegylated interferon alfa and ribavirin are less likely to respond to retreatment unless they demonstrate a virologic response within the first three months of retreatment, lack advanced fibrosis, and can tolerate a more intensive and/or lengthier treatment. Individualized treatment based on viral genotype, viral load, the presence of advanced fibrosis, and initial virologic response can improve therapy for some patients and save resources in others.
