Chronic hepatitis C and no response to antiviral therapy:A perpetual problem

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2007 (EN)
Chronic hepatitis C and no response to antiviral therapy:A perpetual problem (EN)

Cholongitas, E.
Papatheodoridis G.,

SUMMARY No-response to antiviral therapy was observed in the majority of chronic hepatitis C patients treated with interferon alpha (IFN-a) monotherapy, but continues to represent a frequent problem even after treatment with newer, more potent, combination regimens. Non-responding patients represent a fairly heterogeneous group. Subgroups of nonresponders with biochemical but without virological response, or with breakthrough phenomena during therapy probably have a relatively more favorable prognosis. Retreatment with consensus IFN may be relatively effective, while the combination of IFN-a in usual dosage and ribavirin (RIB) achieves sustained virological response in 13% and 21% of such patients treated for 6 and 12 months, respectively. Induction courses of IFN-a in combination with RIB have been found to achieve initial virological response in 36-40% and sustained virological response in 17-26%. Triple antiviral therapy with IFN-a, RIB and amantadine has also been used, but more trials are needed for firm conclusions. Recently, the combination of pegylated IFN-a plus ribavirin was reported to achieve initial virological response in 36-40% of patients non-responding to IFN-a monotherapy or to a combination of IFN-a plus ribavirin. Extensive data suggest that therapy with IFN-a may delay the progression of fibrosis and decrease the incidence of hepatocellular carcinoma even in non-responding chronic hepatitis C patients. Thus, the decision whether or not to discon-tinue the antiviral therapy in non-responders is related to whether therapy aims the clearance of the virus or just a histological benefit. Key words: Chronic hepatitis C, no-response, Interferon, Ribavirin, Amantadine, Induction therapy (EN)




Hellenic Society of Gastroenterology (EN)

Annals of Gastroenterology; Volume 15, No 2 (2002) (EN)

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