title: Shortened peginterferon and ribavirin treatment for chronic hepatitis C.
abstract: BACKGROUND
  Peginterferon alfa and ribavirin combination therapy is an effective treatment for many patients with chronic hepatitis C virus (HCV). Reducing the length of treatment may be advantageous. We performed a systematic review and economic evaluation to assess shorter treatment duration of this regimen.
  
  
  METHODS
  We searched fourteen bibliographic databases (including The Cochrane Library, Medline, and Embase) from 2000 to October 2009 and consulted experts and drug manufacturers. Eligible articles were randomized controlled trials (RCTs) selected according to predefined criteria. We undertook an economic evaluation to assess the cost-effectiveness of shortened treatment versus standard treatment in the UK.
  
  
  RESULTS
  Six trials were included. In the sub-group of patients who had low viral load (LVL) and a rapid virological response (RVR), there were no statistically significant differences in sustained virological response (SVR) rates between patients who received standard treatment (range, 83 percent to 100 percent) and those who received shortened courses (range 84 percent to 96 percent) (24 weeks for genotype 1, 16 weeks for genotype 2/3). Shortened treatment resulted in cost savings, but in some scenarios also resulted in poorer outcome, compared with standard treatment. This requires a judgment to be made on the value of the quality-adjusted life-year loss resulting from adopting a shorter treatment regimen, if shorter treatment is associated with a lower SVR than standard treatment duration.
  
  
  CONCLUSIONS
  For chronic HCV patients who have LVL and achieve an RVR, shortened peginterferon and ribavirin combination therapy could be considered as a viable treatment option.
authors.affiliation: d.hartwell@soton.ac.uk
authors.forename: Debbie
authors.initials: D
authors.lastname: Hartwell
authors.forename: Jeremy
authors.initials: J
authors.lastname: Jones
authors.forename: Louise
authors.initials: L
authors.lastname: Baxter
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shepherd
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000191:economics; D017048:Health Care Costs; D016174:Hepacivirus / Q000187:drug effects*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000191:economics / Q000235:genetics; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008390:Markov Chains; D011092:Polyethylene Glycols; D019057:Quality-Adjusted Life Years; D012254:Ribavirin / Q000627:therapeutic use*; D006113:United Kingdom
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011092:Polyethylene Glycols; D012254:Ribavirin