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Peginterferon Alfa-2a and ribavirin in patients with chronic hepatitis C who have failed prior treatment

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  • claudine intexas
    Gastroenterology. 2004 Apr;126(4):1015-23. Peginterferon Alfa-2a and ribavirin in patients with chronic hepatitis C who have failed prior treatment. Shiffman
    Message 1 of 1 , Apr 6, 2004
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      Gastroenterology. 2004 Apr;126(4):1015-23.

      Peginterferon Alfa-2a and ribavirin in patients with chronic
      hepatitis C who have failed prior treatment.

      Shiffman ML, Di Bisceglie AM, Lindsay KL, Morishima C, Wright EC,
      Everson GT, Lok AS, Morgan TR, Bonkovsky HL, Lee WM, Dienstag JL,
      Ghany MG, Goodman ZD, Everhart JE.

      Background & Aims: The most effective therapy currently available for
      treatment of chronic hepatitis C virus (HCV) is the combination of
      peginterferon and ribavirin. This study evaluated the effectiveness
      of this treatment in patients who were nonresponders to previous
      interferon-based therapy. Methods: The first 604 patients enrolled in
      the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis
      (HALT-C) Trial were evaluated. All were HCV RNA positive, previous
      nonresponders to interferon, with or without ribavirin, and had
      bridging fibrosis or cirrhosis on liver biopsy (Ishak fibrosis stage
      3-6). Patients were retreated with peginterferon alfa-2a 180
      microg/wk plus ribavirin 1000-1200 mg/day. Those with no detectable
      HCV RNA in serum at week 20 continued treatment for a total of 48
      weeks and were then followed for an additional 24 weeks.Results:
      Thirty-five percent of patients had no detectable HCV RNA in serum at
      treatment week 20, and 18% achieved sustained virologic response
      (SVR). Factors associated with an SVR included previous treatment
      with interferon monotherapy, infection with genotypes 2 or 3, a lower
      AST:ALT ratio, and absence of cirrhosis. Reducing the dose of
      ribavirin from >/=80% to </=60% of the starting dose during the first
      20 weeks of treatment was associated with a decline in SVR from 21%
      to 11% (P </= 0.05). In contrast, reducing the dose of peginterferon
      or reducing ribavirin after week 20, when HCV RNA was already
      undetectable, did not significantly affect SVR.Conclusions: Selected
      nonresponders to previous interferon-based therapy can achieve SVR
      following retreatment with peginterferon alfa-2a and ribavirin.

      PMID: 15057741 [PubMed - in process]

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