Nonresponders to hepatitis C virus antiviral therapy: pegylated interferons and beyond.
Nonresponders to prior antiviral therapy are a heterogeneous but growing population of hepatitis C patients in the United States. The likelihood of response to retreatment with pegylated interferon(PEG IFN) and ribavirin (RBV) is largely dependent upon hepatitis C virus genotype and the type, duration, and response to prior antiviral therapy. Investigational trials with clinical and histological end points for nonresponders with advanced fibrosis including maintenance PEG IFN and other antifibrotic agents should be completed in the next 5 years. In the interim, decisions regarding retreatment with PEG IFN and RBV should be made on a case-by-case basis after considering the tolerability of prior treatment, the severity of underlying liver disease, and the anticipated likelihood of response.
Fontana
Robert J
RJ
Department of Medicine, Division of Liver Transplantation, University of Michigan Medical School, 3912 Taubman Center, Ann Arbor, MI 48109-0362, USA. rfontana@umich.edu
D000998:Antiviral Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D004359:Drug Therapy, Combination; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000821:virology; D018579:Patient Selection; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D011994:Recombinant Proteins; D019233:Retreatment; D012254:Ribavirin / Q000627:therapeutic use; D017211:Treatment Failure
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a