Treatment of Hepatitis C in 2011: What Can We Expect? |
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Authors: | Mitchell L Shiffman |
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Institution: | (1) Liver Institute of Virginia, Bon Secours Health System, Mary Immaculate Hospital Medical Pavilion suite 313, 12720 McManus Blvd, Newport News, VA 23602, USA |
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Abstract: | Treatment for chronic hepatitis C virus (HCV) infection is the combination of a peginterferon and ribavirin. Although a fixed
duration of treatment (24 weeks for patients with genotypes 2 and 3 and 48 weeks for patients with all other genotypes) has
been advocated, the best results are likely to be achieved when the duration of therapy is adjusted based on the time to response.
According to the principles of response-guided therapy, patients with rapid virologic response have a high rate of sustained
virologic response (SVR) and a low rate of relapse, and can be treated for 24 weeks regardless of genotype. In contrast, patients
who become HCV RNA undetectable at a slower rate need a longer duration of therapy. Direct-acting antiviral agents are currently
being developed to treat patients with HCV genotype 1. These agents will significantly increase rapid virologic response when
used with peginterferon and ribavirin; according to the concepts of response-guided therapy, such treatment will yield high
rates of SVR with 24 to 28 weeks of treatment. |
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