The treatment of hepatitis C: history, presence and future
The treatment of chronic hepatitis C has made remarkable progress over the past two decades. For interferon-alpha monotherapy, sustained virological response rates were between 2 and 9% in genotype 1 and between 16 and 23% in genotypes 2 and 3. By adjusting treatment duration up to 48 weeks for genotype 1 and combining regular interferon-alpha with ribavirin, sustained response rates could be improved to 28 to 31% in genotype 1 and around 65% in genotypes 2 and 3. Attempts to further increase efficacy included the addition of amantadine without conclusive evidence up till now. With the recent introduction of long-acting pegylated interferon-alpha in combination with ribavirin, sustained virological response rates of 8o% can be obtained in genotypes 2 and 3. However, sustained virological response rates for patients with either genotype 1, nonresponse to prior treatment, cirrhosis or a combination of these characteristics are still less than 50%. In view of results with daily high-dose interferon-alpha induction in combination with prolongation of treatment duration up to 18 months, such patients might benefit from induction and prolonged PEG-IFN-alpha treatment and should be treated in an experimental setting.
|Keywords||Amantadine/therapeutic use, Antiviral Agents/administration & dosage/classification/*therapeutic use, Chronic Disease, Consensus, Drug Therapy, Combination, Hepatitis C/complications/*drug therapy, Humans, Interferon-alpha/therapeutic use, Practice Guidelines, Ribavirin/therapeutic use|
Vrolijk, J.M., de Knegt, R.J., Veldt, B.J., Orlent, H., & Schalm, S.W.. (2004). The treatment of hepatitis C: history, presence and future. Netherlands Journal of Medicine. Retrieved from http://hdl.handle.net/1765/10350