Treatment of chronic hepatitis C: Improved combination therapy |
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Authors: | Gary L Davis MD |
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Institution: | (1) Division of Hepatology, Liver Transplantation, Baylor University Medical Center, Baylor Regional Transplant Institute, 3500 Gaston Avenue, 75246 Dallas, TX, USA |
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Abstract: | There has been considerable progress in the treatment of chronic hepatitis C since the first report that interferon (IFN)
monotherapy was effective in 1989. Early results were meager, with sustained loss of hepatitis C virus from blood in fewer
than 10% of cases. The combination of IFN with the oral nucleoside analogue ribavirin was a major breakthrough in clinical
hepatology; it led to dramatic increases in treatment responses, with 30% to 40% of patients clearing virus. Pegylated IFNs
that have prolonged activity and can be dosed once a week have now replaced standard IFNs. The combination of pegylated IFN
with ribavirin is the new standard of care; it causes sustained loss of virus in more than half of treated patients. Treatment
responses continue to be highly dependent on viral genotype. Patients with genotype 1, the most common type in the United
States, have a sustained clearance rate of 42% to 46%, whereas those with genotype 2 or 3 have a response rate approaching
80%. |
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