Host factors affecting the outcome of treatment of hepatitis C.
The development of peginterferon and ribavirin combination therapy has significantly improved the sustained virologic response (SVR) rates in patients with chronic hepatitis C. However, poor patient adherence to therapy negatively influences drug levels and drug exposure, often preventing the development of an inhibitory drug level. To optimize patient adherence, the clinician must recognize factors predicting low adherence and negotiate a treatment plan that the patient understands and to which he or she commits. If adverse effects become intolerable, continuing patients on a reduced dose rather than withdrawing treatment seems to confer considerable advantage in preserving the chance for attaining an SVR. Results of a head-to-head comparison have demonstrated the possibility that, in cases of dose reduction, levels of peginterferon alfa-2a could remain above the limit of detection, whereas those of peginterferon alfa-2b might not.
Bruno
Raffaele
R
Division of Infectious and Tropical Diseases, IRCCS San Matteo Hospital-University of Pavia, Pavia, Italy.
Sacchi
Paolo
P
Maiocchi
Laura
L
Zocchetti
Cristina
C
Filice
Gaetano
G
D000998:Antiviral Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D001682:Biological Availability; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D034982:Integration Host Factors; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000493:pharmacokinetics; D008111:Liver Function Tests; D008297:Male; D010349:Patient Compliance; D011092:Polyethylene Glycols / Q000008:administration & dosage* / Q000493:pharmacokinetics; D011379:Prognosis; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage* / Q000493:pharmacokinetics; D012307:Risk Factors; D012720:Severity of Illness Index; D014018:Tissue Distribution; D016896:Treatment Outcome; D019562:Viral Load
D000998:Antiviral Agents; D034982:Integration Host Factors; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a