[When and how should hepatitis C be treated?].
Treatment results of hepatitis C have improved markedly during the last years with the combination pegylated interferons and ribavirin. The indications for evaluation for therapy is positive HCV-PCR and lack of contraindications for treatment. Liver biopsy is considered only for those with suspicion of other concomitant liver disease or in patients, where retreatment is considered. The length of therapy is individualised and based on rapid virological response in both genotype 2/3 and in genotype 1. Patients with genotype 2/3 with negative HCV-PCR at week 4 and younger than 40 years are treated for 12 weeks only with 80-90 % response rate. In Finland some 70 % of the patients with genotype 2/3 can successfully be treated with 12 weeks therapy. In genotype 1 patients with rapid virological response, regardless of age are treated for 24 weeks. Treatment is discontinued for those, who are still positive at week 24. Early intervention with tailored combination therapy before cirrhosis has developed improves treatment results, patient's overall prognosis and reduces cost of medication and surveillance. New protease inhibitors, telaprevir and boceprevir combined with PEG-interferons and ribavirin might be a future option for those not achieving early virological response.
Färkkilä
Martti
M
HYKS, medisiininen tulosyksikkö, Gastroenterologian klinikka, HUS.
D000367:Age Factors; D000998:Antiviral Agents / Q000008:administration & dosage*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005387:Finland; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D006526:Hepatitis C / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000008:administration & dosage / Q000627:therapeutic use; D018579:Patient Selection; D011480:Protease Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D012254:Ribavirin / Q000008:administration & dosage; D016896:Treatment Outcome
D000998:Antiviral Agents; D011480:Protease Inhibitors; D012254:Ribavirin; D007372:Interferons