Approach to the management of patients with chronic hepatitis C who failed to achieve sustained virologic response.
The combination of peginterferon and ribavirin is the most effective therapy for patients with chronic hepatitis C virus (HCV) infection. Although more than half of all patients are able to achieve a sustained virologic response (SVR), a significant proportion of patients, particularly those with genotype 1, fail to have undetectable HCV RNA during treatment or relapse after completing therapy with return of detectable HCV RNA. The management of these patients creates a formidable challenge. This article outlines various strategies for patients who have failed to achieve SVR and discusses the merits of different approaches to management.
Sethi
Amrita
A
Hepatology Section, Virginia Commonwealth University Medical Center, Box 980341, Richmond, VA 23298, USA.
Shiffman
Mitchell L
ML
D000547:Amantadine / Q000008:administration & dosage; D000998:Antiviral Agents / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D019698:Hepatitis C, Chronic / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007370:Interferon Type I / Q000008:administration & dosage* / Q000009:adverse effects; D016898:Interferon-alpha; D008019:Life Style; D011994:Recombinant Proteins; D012254:Ribavirin / Q000008:administration & dosage* / Q000009:adverse effects; D017211:Treatment Failure; D016312:Treatment Refusal; D019562:Viral Load
D000998:Antiviral Agents; D007370:Interferon Type I; D016898:Interferon-alpha; D011994:Recombinant Proteins; D012254:Ribavirin; C050739:interferon alfacon-1; D000547:Amantadine