title: [Treatment of patients with recurrence or who do not respond to the first treatment against hepatitis C].
abstract: The current criteria to confirm the absence of therapeutic response to HCV is based on the viral findings. Lack of response is defined as the failure to achieve a negative serological response to the virus in peripheral blood (serum or plasma) after 12 weeks of treatment with interferon alpha (2a or 2b), or 24 weeks of treatment with IFN and ribavirin. Up to 60% of patients treated with standard IFN alpha and ribavirin are considered non-responders. According to viral genotype, figures are still worse in the group with genotype 1. Recently, the use of pegylated interferon allowed the reduction of the number of non-responding patients. The investigators propose different approaches in the search for better therapeutic strategies. The most effective of them all are the addition of ribavirin to the therapeutic scheme and the use of pegylated interferon which greatly increased the number of responders. Nevertheless, there are still many patients who are resistant to therapy. These are the proposed therapeutic alternatives for non-respondent patients: 1. Another tretment cycle with standard IFN and ribavirin (low probability) 2. Another treatment cycle with pegylated IFN and ribavirin. 3. Another treatment cycle with IFN, ribavirin and amantadine. 4. Another treatment cycle with IFN, ribavirin and timosine. 5. Other antiviral agents. It's important to clarify that "real non-responders" are those patients who remain positive in the viral load tests after 12-24 months of treatment. On the other hand, patients who "escape from treatment" or those with "recurrence" are not real non-responders, compared to those who are negative after 12-24 weeks of treatment.
authors.affiliation: Dirección del Centro de Investigación Farmacológica y Biotecnología, Fundación Clínica Médica Sur. Puente de Piedra # 150, Col. Toriello Guerra, Deleg. Tlalpan. jpoo@medicasur.org.mx
authors.forename: Jorge Luis
authors.initials: JL
authors.lastname: Poo
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use; D012008:Recurrence; D012254:Ribavirin / Q000627:therapeutic use
chemical_list: D000998:Antiviral Agents; D012254:Ribavirin; D007372:Interferons
vernacular_title: Tratamiento de los pacientes con recaída o que no responden al primer tratamiento contra el virus de la hepatitis C.