[Only 1 injection per week brings a 60% chance of healing. New therapy recommendations in chronic hepatitis C].
Antiviral therapy can now eliminate the hepatitis C virus in some 60% of all hepatitis patients. The results of recent studies have led to new recommendations for treatment: patients with HCV genotype I should be treated with pegylated interferons and 1000 or 1200 (patients weighing > 75 kg) mg ribavirin for 48 weeks, while patients with genotypes 2/3 should receive only 800 mg ribvavirin (irrespective of body weight) for 24 weeks. Data provided by two large drug-approval studies with PEG interferons alpha 2a and 2b show that the initial decrease in HCV-RNA determines the sustained viral response. Patients with genotype 1 have only a minimal chance (0-3%) of a sustained viral response if HCV-RNA is not reduced by at least a factor of 100 by the 12th week of treatment, and in these patients, treatment should then be discontinued. Pre-treatment determination of HCV genotype and HCV-RNA is mandatory to establish the chances of attaining a sustained viral response. Liver biopsy is necessary to determine the stage of disease and the urgency of treatment. In young persons with biochemical and histological inflammatory activity treatment is usually indicated. In asymptomatic older patients with no liver fibrosis, however, in particular those with a limited chance of a sustained viral response or concomitant disease, the indication for antiviral therapy is doubtful.
Niederau
C
C
Klinik für Innere Medizin, St. Josef Hospital, Oberhausen.
D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007279:Injections, Subcutaneous; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000009:adverse effects; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000009:adverse effects; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage* / Q000009:adverse effects; D019562:Viral Load
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a