Therapy of chronic hepatitis C in patients with relapse
Journal Title: Αρχεία Ελληνικής Ιατρικής - Year 2003, Vol 20, Issue 6
Abstract
Interferon-α (IFN-α) in a dose of 3 MU, thrice weekly, for 12 months, has a limited (around 20%) sustained virologic response in naive patients with chronic hepatitis C. This review discusses therapy options for patients with hepatitis C virus who relapse after an initial virologic response to treatment. In patients who have relapsed after IFN-α monotherapy two options can be considered: To treat with a combination of IFN-α 3 MU thrice weekly and ribavirin 1000–1200 mg daily for 6 months providing there are no contraindications to ribavirin, or to treat with a high dose (more than 3 MU or 9 μg, thrice weekly) of IFN-α for 12 months. In both options, HCV-RNA should be checked after 3 months and therapy should be discontinued if HCV-RNA remains positive. This retreatment gives a 50% general sustained viral response. Histologic improvement occurs in nearly two thirds of patients retreated with combination therapy and is most pronounced in those who lose serum HCV-RNA. The viral genotype and HCV-RNA levels influence the rate of response to retreatment. The sustained viral response in genotype 1 patients is 29% using combination therapy for 6 months and is thought to be better with longer therapy. The presence of fibrosis or cirrhosis does not appear to decrease the response to combination therapy. Six to 9% of patients discontinue combination therapy because of an adverse event. In conclusion, IFN-α is used in combination with ribavirin or alone in high doses in patients who relapse after initial treatment with IFN-α. For patients who relapse after combination therapy, high dose IFN-α or a combination of pegylated IFN-α and ribavirin, with or without induction therapy, can possibly offer a sustained virologic response.
Authors and Affiliations
S. DOURAKIS
Keywords
Related Articles
- EP ID EP154723
- DOI -
- Views 88
- Downloads 0
Electromagnetic fields, human health and quality of life: An update
Human exposure to electromagnetic fields is a part of everyday life in modern societies and there is concern about the possible effects on human health. This review presents the latest epidemiological data on human expos...
May affect renal function
No abstract available
Gastroenterology-Endoscopy Quiz –Case 7
No abstract available
Οικογενής πολυποδίαση. Τι νεότερο στη διάγνωση και τη θεραπεία<br />
Rupture of ectopic pregnancy (ruptured ectopic sac in the right Fallopian tube and active bleeding): Emergency CT findings
No abstract available