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Treating Non-responders

March 10, 2005

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I’m not a mathematician, but it seems to me that one with those skills could discern from this article what the SVR rate among genotype 1 patients is after initial treatment and what it is after retreatment.

The article states that about 45% of patients are unresponsive to treatment. We know that genotypes 2, 3, are more responsive (each one is different, but I’ve heard that two is up over 85%).

They mention the results for non 1 genotypes but not for 1.

If anyone reading this can do the math, please post it.

Thanks.

Treatment of chronic hepatitis C in patients unresponsive to interferon

Gastroenterologie
Clinique et Biologique
Volume 29 No 2 de March 2005

Aim

About 45% of patients with chronic hepatitis C are unresponsive to the present reference treatment combining pegelated interferon plus ribavirin; before pegylated interferon was available the non-response rate was around 60%. This open multicenter pilot study, initiated before pegylated interferon became available, was designed to evaluate, in patients unresponsive to interferon monotherapy, the rate of biological and virological response and side-effects of the ribivirin- alpha 2b interferon combination.

Methods

The combination protocol was ribavirin (1 to 1.2 g/d) plus alpha 2b interferon at induction doses (9 MU/d the first week; 4.5 MU/d the eleven following weeks; 3 MU/2 days the 36 following weeks).

Results

Among the 27 included patients, 17 (63%) were viremia-negative (PCR) after 12 weeks of treatment, 9 (33%) were complete responders (undetectable viremia and normal transaminases) at the end of treatment (48 weeks) and of follow-up (72 weeks). Patients with non-1, non-4 genotypes who derived full benefit from this therapeutic strategy (6/7 (86%) were complete responders: 4/5 with genotype 3 and 2/2 with genotype 5). Quality-of-life was impaired during treatment, especially during the first 12 weeks of high-dose interferon therapy.

Conclusion

While waiting for new therapeutic possibilities, these good results suggest interferon induction at the beginning of treatment remains a valid option.

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