title: Discontinuation of pegylated interferon plus ribavirin in patients who are not responding to therapy -- patients' views of early cessation of therapy.
abstract: BACKGROUND
  Current therapy for chronic hepatitis C infection involves a course of pegylated interferon and ribavirin. Patients who do not show a virological response after 12 weeks of therapy have a low probability of sustained virological response and it is therefore recommended that such patients stop treatment.
  
  
  OBJECTIVE
  To assess patients' views of early treatment cessation.
  
  
  METHODS
  We conducted a open-labelled study in three UK centres, in which patients with biopsy-proven chronic hepatitis C requiring therapy were offered the choice of a full course of therapy with 40 kDa pegylated interferon-alpha 2a plus ribavirin (24 or 48 weeks depending on viral genotype) or early cessation if therapy had failed after 12 weeks.
  
  
  RESULTS
  Ninety-five participants were enrolled and the majority (69%) did not wish to discontinue therapy even if it had low probability of success. In this unselected UK population, very few patients (4%) did not achieve an early virological response with the 40-kDa pegylated interferon-alpha 2a plus ribavirin and two of the four early virological non-responders decided to continue therapy.
  
  
  CONCLUSIONS
  Early discontinuation of 'ineffective' anti-viral therapy may prove less popular with patients than with health care providers, and further patient-directed education regarding the cost-effectiveness of therapy will be needed if early discontinuation of unsuccessful therapy is to be accepted by patients.
authors.affiliation: Department of Gastroenterology, Hepatobiliary Group, Queen Mary's School of Medicine and Dentistry, Barts and The Royal London, London, UK. raymonddsou@yahoo.com
authors.forename: R
authors.initials: R
authors.lastname: D'Souza
authors.forename: J
authors.initials: J
authors.lastname: Main
authors.forename: M
authors.initials: M
authors.lastname: Crossey
authors.forename: W
authors.initials: W
authors.lastname: Rosenberg
authors.forename: I M
authors.initials: IM
authors.lastname: Murray-Lyon
authors.forename: C
authors.initials: C
authors.lastname: Hayward
authors.forename: G R
authors.initials: GR
authors.lastname: Foster
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D001294:Attitude to Health; D015331:Cohort Studies; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D017211:Treatment Failure
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a