Moving towards the optimal treatment of chronic hepatitis C.
Almost 10 years after the first report of the effectiveness of interferon (IFN) for chronic NANB hepatitis, the optimal treatment for chronic hepatitis C is still a matter of debate. The issue of the relative importance of higher doses versus a longer period of therapy remains unsettled, since the long-term response may be a function of the total dose received. Controlled studies have shown that high doses of IFN (5-6 MU t.i.w.), a long period of therapy (> 12 months) and the administration of a large total dose are all associated with a higher cure rate. However, these measures can cause more adverse effects and certainly cost more than the current schedule of 3 MU t.i.w. for a period of 6 months. The standard schedule may be appropriate for subjects with pre-treatment features predictive of a good response (non-Ib genotype, low viraemia, absence of cirrhosis). Alternative treatment schedules or combination therapy with interferon/ribavirin should be considered in subjects with normalized alanine aminotransferase (ALT) levels, but who are still viremic after three months of therapy, as well as in relapsers and in non-responders.
Cammà
C
C
ISMEDA-CNR, University of Palermo, Italy.
Giunta
M
M
Almasio
P
P
Di Marco
V
V
Craxì
A
A
D000998:Antiviral Agents / Q000627:therapeutic use; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D006526:Hepatitis C / Q000628:therapy*; D006801:Humans; D007372:Interferons / Q000009:adverse effects / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use
D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons