, Volume 2, Issue 1, pp 32-39

Treatment of chronic hepatitis C in patients who have failed to respond to IFN or IFN and ribavirin combination therapy

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Approximately 45% of patients with chronic hepatitis C infection fail to achieve a sustained virologic response when treated with pegylated interferon (IFN) and ribavirin combination therapy. The lack of early virologic response after 12 to 24 weeks of therapy can be a reliable indicator of those who will not benefit from continuing the treatment for 48 weeks. The presence of genotype 1, high viral load, and advanced fibrosis are among the factors that can predict those patients who have higher rates of nonresponse. Nonresponders to IFN monotherapy and IFN plus ribavirin combination therapy can benefit from retreatment with pegylated IFN and ribavirin combination therapy. Treatment options for nonresponders to pegylated IFN and ribavirin are being investigated in several trials. The role of maintenance pegylated IFN is also under investigation, although preliminary evidence suggests that some patients may derive benefit.