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Shorter Treatment for Some Patients with Chronic Hepatitis C

A 12-week regimen of combination therapy was effective for some patients with genotype 2 or 3 infections.

Patients with hepatitis C virus (HCV) genotypes 2 and 3 are more responsive to treatment than are those with genotype 1. In this Italian trial that included 283 patients with HCV genotype 2 or 3, researchers determined whether the duration of treatment with peginterferon plus ribavirin could be shortened. Patients were randomized to a standard 24-week treatment group (70 patients) or to a "variable-duration" group (213 patients). In the latter group, patients with negative test results for HCV RNA at 4 weeks received only 12 weeks of treatment, and those with positive test results received full 24-week treatment courses.

In the standard group, 76% of patients had sustained virologic responses (no detectable HCV RNA at 24 weeks after therapy had been completed). In the variable-duration group, about two thirds of patients were negative for HCV RNA at 4 weeks and thus received only 12 weeks of treatment; their response rate was 85%. Eighty patients in the variable-duration group were positive for HCV RNA at 4 weeks and received full 24-week courses of treatment; their response rate was 64%.

Comment: Among chronic hepatitis C patients with HCV genotype 2 or 3, 12-week courses of peginterferon plus ribavirin are sufficient for those who test negative for HCV RNA after 4 weeks of therapy. These findings are particularly important given the expense and toxicity of prolonged treatment for HCV infections.

— Allan S. Brett, MD

Published in Journal Watch General Medicine July 26, 2005

Citation(s):

Mangia A et al. Peginterferon alfa-2b and ribavirin for 12 vs. 24 weeks in HCV genotype 2 or 3. N Engl J Med 2005 Jun 23; 352:2609-17.

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