Virology Research Today is a free monthly online journal that collates and summarizes the latest research about Virology, including details on viruses, pathology, classification, definitions.

Approach to the management of patients with chronic hepatitis C who failed to achieve sustained virologic response.

Sethi A, Shiffman ML

Hepatology Section, Virginia Commonwealth University Medical Center, Box 980341, Richmond, VA 23298, USA.

The combination of PEGIFN and RBV is the most effective therapy for patients with chronic hepatitis C. Although more than half of all patients are able to achieve SVR, a significant proportion of patients, particularly those with genotype 1, fail to have undetectable HCV RNA during treatment or relapse after completing therapy with return of detectable HCV RNA. An approach in the management of these patients is to identify factors that could have led to the NR or relapse and that could be corrected before or during a second course of therapy. Because fibrosis progression occurs slowly over decades for many patients with chronic hepatitis C, avoiding alcohol or other factors that could lead to fibrosis progression may be sufficient for the vast majority of patients. Other options that could be considered in patients who have more advanced disease include retreating with one of several new antiviral agents; retreating with higher doses of IFN or PEGIFN and RBV; or using IFN, PEGIFN, or RBV monotherapy long-term as maintenance therapy. The safety and efficacy of these approaches is being evaluated in numerous clinical trials.

Published 10 March 2006 in Infect Dis Clin North Am, 20(1): 115-35.
Full-text of this article is available online (may require subscription).

© 2005-2008 Virology Research Today. All Rights Reserved.