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Current treatment of choice for chronic hepatitis C infection.

Yasin T, Riley TR, Schreibman IR - Infect Drug Resist (2011)

Bottom Line: Treatment is focused on the chronic form of the disease, because the acute one tends to be self-limiting.We conclude that combination therapy with pegylated interferon and ribavirin remains the initial treatment of choice.New research focusing on adjuvant therapies, such as protease and polymerase inhibitors, has yielded early data that appear to be promising.

View Article: PubMed Central - PubMed

Affiliation: Penn State Hershey Medical Center and College of Medicine, Pennsylvania, USA.

ABSTRACT
More than three million Americans have chronic hepatitis C infection, and the disease remains one of the most common blood-borne infections in the US. Treatment is focused on the chronic form of the disease, because the acute one tends to be self-limiting. In this article, we review the recent literature regarding the most effective therapy against hepatitis C infection, to confirm the current treatment of choice for the disease. We conclude that combination therapy with pegylated interferon and ribavirin remains the initial treatment of choice. New research focusing on adjuvant therapies, such as protease and polymerase inhibitors, has yielded early data that appear to be promising.

No MeSH data available.


Related in: MedlinePlus

Likelihood of achieving a sustained viral response with different modalities of treatment, for hepatitis C virus genotype 1 and genotypes 2 and 3.Abbreviation: SVR, sustained viral response.
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f1-idr-4-011: Likelihood of achieving a sustained viral response with different modalities of treatment, for hepatitis C virus genotype 1 and genotypes 2 and 3.Abbreviation: SVR, sustained viral response.

Mentions: Combination therapy of peginterferon alfa and ribavirin continues to be the optimal initial treatment for HCV on the basis of the findings of three major trials (see Figure 1). The first trial, carried out by Manns et al included 1530 patients with chronic hepatitis C who were assigned to one of three treatment arms.15 The first arm received interferon alfa-2b (3 MU subcutaneously three times per week) and ribavirin 1000–1200 mg/day. The second arm received peginterferon alfa-2b (1.5 μg/kg/week) and 800 mg/day ribavirin, while the third arm received peginterferon alfa-2b (1.5 μg/kg/week for four weeks then 0.5 μg/kg/week) and ribavirin 1000–1200 mg/day, for a total of 48 weeks. The results of this trial showed that the SVR rate was significantly higher in the higher-dose peginterferon group (54%) than in the lower-dose peginterferon (47%) or interferon (47%) groups. Among patients with HCV genotype 1 infection, the corresponding SVR rates were 42%, 34%, and 33%. The SVR rate for patients with genotypes 2 and 3 infection was about 80% for all treatment groups. This demonstrated that the most effective therapy is the combination of peginterferon alfa-2b 1.5 μg/kg/week and ribavirin, with the most benefit seen in patients with HCV genotype 1 infection. In addition, the study found that the side effects seen with the peginterferon alfa-2b and ribavirin combination were similar to those with interferon alfa-2b and ribavirin. There was an increase in influenza-like effects with the peginterferon, although the authors related that to the higher dose of peginterferon used in the trial.


Current treatment of choice for chronic hepatitis C infection.

Yasin T, Riley TR, Schreibman IR - Infect Drug Resist (2011)

Likelihood of achieving a sustained viral response with different modalities of treatment, for hepatitis C virus genotype 1 and genotypes 2 and 3.Abbreviation: SVR, sustained viral response.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3108752&req=5

f1-idr-4-011: Likelihood of achieving a sustained viral response with different modalities of treatment, for hepatitis C virus genotype 1 and genotypes 2 and 3.Abbreviation: SVR, sustained viral response.
Mentions: Combination therapy of peginterferon alfa and ribavirin continues to be the optimal initial treatment for HCV on the basis of the findings of three major trials (see Figure 1). The first trial, carried out by Manns et al included 1530 patients with chronic hepatitis C who were assigned to one of three treatment arms.15 The first arm received interferon alfa-2b (3 MU subcutaneously three times per week) and ribavirin 1000–1200 mg/day. The second arm received peginterferon alfa-2b (1.5 μg/kg/week) and 800 mg/day ribavirin, while the third arm received peginterferon alfa-2b (1.5 μg/kg/week for four weeks then 0.5 μg/kg/week) and ribavirin 1000–1200 mg/day, for a total of 48 weeks. The results of this trial showed that the SVR rate was significantly higher in the higher-dose peginterferon group (54%) than in the lower-dose peginterferon (47%) or interferon (47%) groups. Among patients with HCV genotype 1 infection, the corresponding SVR rates were 42%, 34%, and 33%. The SVR rate for patients with genotypes 2 and 3 infection was about 80% for all treatment groups. This demonstrated that the most effective therapy is the combination of peginterferon alfa-2b 1.5 μg/kg/week and ribavirin, with the most benefit seen in patients with HCV genotype 1 infection. In addition, the study found that the side effects seen with the peginterferon alfa-2b and ribavirin combination were similar to those with interferon alfa-2b and ribavirin. There was an increase in influenza-like effects with the peginterferon, although the authors related that to the higher dose of peginterferon used in the trial.

Bottom Line: Treatment is focused on the chronic form of the disease, because the acute one tends to be self-limiting.We conclude that combination therapy with pegylated interferon and ribavirin remains the initial treatment of choice.New research focusing on adjuvant therapies, such as protease and polymerase inhibitors, has yielded early data that appear to be promising.

View Article: PubMed Central - PubMed

Affiliation: Penn State Hershey Medical Center and College of Medicine, Pennsylvania, USA.

ABSTRACT
More than three million Americans have chronic hepatitis C infection, and the disease remains one of the most common blood-borne infections in the US. Treatment is focused on the chronic form of the disease, because the acute one tends to be self-limiting. In this article, we review the recent literature regarding the most effective therapy against hepatitis C infection, to confirm the current treatment of choice for the disease. We conclude that combination therapy with pegylated interferon and ribavirin remains the initial treatment of choice. New research focusing on adjuvant therapies, such as protease and polymerase inhibitors, has yielded early data that appear to be promising.

No MeSH data available.


Related in: MedlinePlus