title: [Hepatitis C: which strategy in case of treatment failure ?].
abstract: After a treatment by peginterferon alpha and ribavirin, the percentages of non response and relapse are approximatively 33 and 18 % respectively. These treatment failures may be due either to viral resistance or to an insufficient treatment. The prevention of treatment failure is based on a good knowledge of the predictive factors of failure before and during the treatment. Among the patients who did not respond to interferon alpha and ribavirin, a new treatment with peginterferon alpha-2b and ribavirin makes it possible to obtain 45 % of sustained virological response (SVR) among the relapsers and 17 % of SVR among the non responders. Among the patients who did not respond to peginterferon alpha and ribavirin, a new treatment with peginterferon alpha-2b and ribavirin makes it possible to obtain 36 % of SVR among the relapsers and only 4 % of SVR among the non responders. New therapeutic strategies are necessary for the non responders. Until now no new therapeutic strategy allowed a significant benefit in term of SVR. Protease inhibitors are currently tested in non responders but there are some concerns about the risk of selection of multi-resistant strains.
authors.affiliation: Hépato-gastroentérologie, INSERM 724, CHU de Nancy, 54500 Vandoeuvre-les-Nancy, France. jp.bronowicki@chu-nancy.fr
authors.forename: J-P
authors.initials: JP
authors.lastname: Bronowicki
authors.forename: D
authors.initials: D
authors.lastname: Larrey
authors.forename: A
authors.initials: A
authors.lastname: Tran
authors.forename: C
authors.initials: C
authors.lastname: Perronne
authors.forename: J
authors.initials: J
authors.lastname: Denis
authors.forename: J-F
authors.initials: JF
authors.lastname: Cadranel
authors.forename: C
authors.initials: C
authors.lastname: Trépo
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D024882:Drug Resistance, Viral; D004359:Drug Therapy, Combination; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; 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; C417083:peginterferon alfa-2b; C100416:peginterferon alfa-2a