Skip to main content
SpringerLink
Log in
Book cover

Chronic Viral Hepatitis pp 71–96Cite as

Current and Future Therapy of Chronic Hepatitis C

  • Chapter
  • First Online:

  • 882 Accesses

Part of the book series: Clinical Gastroenterology ((CG))

Abstract

Key Principles

The current standard of care for treatment of chronic hepatitis C is once weekly pegylated interferon and daily oral ribavirin. The optimal treatment regimen is determined by viral genotype, patient weight, and the initial virus response to therapy, termed early virologic response (EVR). Non-responders can be identified after the first 12 weeks of treatment so that therapy can be stopped.

Treatment of chronic hepatitis C with antiviral therapy requires close monitoring since about 30% of patients require dose modifications for cytopenia or side effects.

Approximately half of treated patients are cured of their infection. Treatment response, termed sustained viral response (SVR), is associated with resolution of inflammation and fibrosis regression. Patients with cirrhosis who achieve an SVR have no further risk of liver failure and the risk of liver cancer is markedly reduced, though not eliminated.

Some groups of patients have a lower chance of response to treatment than others. Recent studies suggest that higher doses of antiviral drugs might be of benefit in these cases. Patients with advanced cirrhosis or extrahepatic manifestations of hepatitis C infection are best treated by a physician, who has considerable experience with these drugs.

New virus-specific antiviral agents are in development but it appears that they will need to be given in conjunction with interferon and ribavirin. It is hoped that these new drugs will improve efficacy and perhaps shorten the required duration of treatment. These drugs, if approved, will probably not be available before 2010.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Hutin Y, Kitler ME, et al. Global burden of disease for hepatitis C. J Clin Pharmacol 2004; 44:20–9.

    Article  Google Scholar 

  2. Frank C, Mohamed MK, Strickland GT, et al. The role of parenteral anti-schistosomal therapy in the spread of hepatitis c virus in Egypt. Lancet 2000; 355:887–91.

    Article  CAS  PubMed  Google Scholar 

  3. Gregory LA, Annemarie W, Edger PS, Geraldine MM, Wendi LK, Miriam JA. The prevalence of hepatitis C virus infection in the United States 1999 through 2002. Ann Int Med 2006; 144:705–14.

    Google Scholar 

  4. Alter MJ, Kruszon-Moran D, Nainan OV, et al. The prevalence of hepatitis C virus infection in the United States, 1988 through 1994 N Eng J Med 1999; 341:556–62.

    Article  CAS  Google Scholar 

  5. Alter MJ. The epidemiology of acute and chronic hepatitis C. Clin Liver Dis. 1997; 1:559–68.

    Article  CAS  PubMed  Google Scholar 

  6. Steele CB, Melendez-Morales L, Campoluci R, DeLuca N, Dean HD. Health disparities in HIV/AIDS, viral hepatitis, sexually transmitted disease, and tuberculosis: Issues, burden and response. A retrospective review, 2000–2004. Atlanta, GA: Department of Health and Human Services, Center for Disease Control and Prevention, November, 2007. Available at http://www.cdc.gov/nchhstp/healthdisparities/.

  7. Davis GL, Albright JE, Cook SF, Rosenberg DM. Projecting the future healthcare burden from hepatitis C in the United States. Liver Transpl 2003; 9:331–8.

    Article  PubMed  Google Scholar 

  8. Armstrong GL, Alter MJ, McQuillen GM, Margolis HS. The past incidence of hepatitis C virus infection: Implications for the future burden of chronic liver disease in the United States. Hepatology 2000; 31:777–82.

    Article  CAS  PubMed  Google Scholar 

  9. Davis GL, Balart LA, Schiff ER, et al. Treatment of chronic hepatitis C with recombinant interferon alfa: A multicenter randomized controlled trial. New Engl J Med 1989; 321:1501–6.

    Article  CAS  PubMed  Google Scholar 

  10. Poynard T, Leroy V, Cohard M, et al. Meta-analysis of interferon randomized trials in the treatment of viral hepatitis C: Effects of dose and duration. Hepatology 1996; 24:778–89.

    Article  CAS  PubMed  Google Scholar 

  11. McHutchison JG, Gordon S, Schiff ER, et al. Interferon alfa-2b monotherapy versus interferon alfa-2b plus ribavirin as initial treatment for chronic hepatitis C: Results of a U.S. multicenter randomized controlled study. New Engl J Med 1998; 339:1485–92.

    Article  CAS  PubMed  Google Scholar 

  12. Manns MP, McHutchison JG, Gordon S, et al. Peginterferon alfa-2b plus ribavirin compared to interferon alfa-2b plus ribavirin for the treatment of chronic hepatitis C: A randomized trial. Lancet. 2001; 358:958–65.

    Article  CAS  PubMed  Google Scholar 

  13. Fried MW, Shiffman ML, Reddy R, et al. Peg-interferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 2002; 347:975–82.

    Article  CAS  PubMed  Google Scholar 

  14. Peters M, Davis GL, Dooley JS, et al. The interferon system in acute and chronic viral hepatitis. In Popper H, Schaffner F (eds): Progress in Liver Diseases, vol. 8. New York: Grune and Stratton, 1986, p 453–67.

    Google Scholar 

  15. Wang YS, Youngster S, Bausch J, Zhang R, McNemar C, Wyss DF. Identification of the major positional isomer of pegylated interferon alpha-2b. Biochemistry 2000; 39:10,634–40.

    CAS  Google Scholar 

  16. Glue P, Fang JW, Rouzier-Panis R, et al. Pegylated interferon-alpha2b: Pharmacokinetics, pharmacodynamics, safety, and preliminary efficacy data. Clin Pharmacol Ther 2000; 68:556–67.

    Article  CAS  PubMed  Google Scholar 

  17. Pedder SC. Pegylation of interferon alfa: Structural and pharmacokinetic properties. Semin Liver Dis 2003; 23(Suppl 1):19–22.

    PubMed  Google Scholar 

  18. Heathcote EJ, Shiffman ML, Cooksley WG, et al. Peginterferon alfa-2a in patients with chronic hepatitis C and cirrhosis. N Engl J Med 2000; 343:1673–80.

    Article  CAS  PubMed  Google Scholar 

  19. Zeuzem S, Feinman SV, Rasenack J, et al. Peginterferon alfa-2a in patients with chronic hepatitis C. N Engl J Med 2000; 343:1666–72.

    Article  CAS  PubMed  Google Scholar 

  20. Lindsay KL, Trepo C, Heintges T, et al. A randomized, double-blind trial comparing pegylated interferon alfa-2b to interferon alfa-2b as initial treatment for chronic hepatitis C. Hepatology. 2001; 34:395–403.

    Article  CAS  PubMed  Google Scholar 

  21. Modi MW, Fulton JS, Buckmann DK, Wright TL, Moore DJ. Clearance of pegylated (40 kDa) interferon alfa-2a is primarily hepatic (abstract). Hepatology 2000; 32:371A.

    Google Scholar 

  22. Patterson JL, Fernandez-Larson R. Molecular action of ribavirin. Rev Infect Dis 1990; 12:1132–46.

    Google Scholar 

  23. Crumpacker CS. Overview of ribavirin treatment of infection caused by RNA viruses. In: RA Smith, V Knight, and Smith JAD, eds. Clinical Applications of Ribavirin. Orlando: Academic Press, 1984. pp. 33–8.

    Google Scholar 

  24. Vo NV, Young KC, Lai MM. Mutagenic and inhibitory effects of ribavirin on hepatitis C virus RNA polymerase. Biochemistry 2003; 42:10,462–71.

    CAS  Google Scholar 

  25. Reichard O, Andersson J, Schvarcz R, et al. Ribavirin treatment for chronic hepatitis C. Lancet 1991; 337:1058–61.

    Article  CAS  PubMed  Google Scholar 

  26. Di Bisceglie AM, Shindo M, Fong T-L, et al. Pilot study of ribavirin therapy for chronic hepatitis C. Hepatology 1992; 16:649–54.

    Article  PubMed  Google Scholar 

  27. Bodenheimer HC, Lindsay KL, Davis GL, et al. Tolerance and efficacy of oral ribavirin treatment of chronic hepatitis C: A multicenter trial. Hepatology 1997; 26:473–7.

    Article  CAS  PubMed  Google Scholar 

  28. Poynard T, Marcellin P, Lee S, et al. Randomised trial of interferon alpha2b plus ribavirin for 48 weeks or for 24 weeks versus interferon alpha-2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus. Lancet 1998; 352:1426–32.

    Article  CAS  PubMed  Google Scholar 

  29. Reichard O, Norkrans G, Fryden A, et al. Alfa-interferon and ribavirin versus alfa-interferon alone as therapy for chronic hepatitis C – a randomized, double-blind, placebo-controlled study. Lancet 1998; 351:83–7.

    Article  CAS  PubMed  Google Scholar 

  30. Zeuzem S, Schmidt JM, Lee JH, et al. Hepatitis C virus dynamics in vivo: Effect of ribavirin and interferon alfa on viral turnover. Hepatology 1998; 28:245–52.

    Article  CAS  PubMed  Google Scholar 

  31. McHutchison JG, Poynard T. Combination therapy with interferon plus ribavirin for the initial treatment of chronic hepatitis C. Semin Liver Dis 1999; 19: 57–65.

    CAS  PubMed  Google Scholar 

  32. Hadziyannis SJ, Sette H, Morgan TR, et al. Peginterferon-alpha2a and ribavirin combination therapy in chronic hepatitis C: A randomized study of treatment duration and ribavirin dose. Ann Intern Med 2004; 140:346–55.

    CAS  PubMed  Google Scholar 

  33. Jacobson IM, Brown RS Jr, Freilich B, et al. Peginterferon alfa-2b and weight-based or flat-dose ribavirin in chronic hepatitis C patients: a randomized trial. Hepatology 2007; 46:971–81.

    Article  CAS  PubMed  Google Scholar 

  34. Jensen D, Morgan T, Marcellin P, et al. Rapid virological response at week 4 (RVR) of peginterferon alfa-2a (40KD) (PEGASYS®) plus ribavirin (RBV, COPEGUS®) treatment predicts sustained virological response (SVR) after 24 weeks in genotype 1 patients (abstract). Hepatology 2005; 42:650A.

    Article  Google Scholar 

  35. Zeuzem S, Buti M, Ferenci P, et al. Efficacy of 24 weeks treatment with peginterferon alfa-2b plus ribavirin in patients with chronic hepatitis C infected with genotype 1 and low pretreatment viremia. J Hepatol 2006; 44:97–103.

    Article  CAS  PubMed  Google Scholar 

  36. von Wagner M, Huber M, Berg T, et al. Peginterferon-alpha-2a (40KD) and ribavirin for 16 or 24 weeks in patients with genotype 2 or 3 chronic hepatitis C. Gastroenterology 2005; 129:522–7.

    Google Scholar 

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

    Article  CAS  PubMed  Google Scholar 

  38. Dalgard O, Bjøro K, Hellum KB, Myrvang B, et al. Treatment with pegylated interferon and ribavarin in HCV infection with genotype 2 or 3 for 14 weeks: A pilot study. Hepatology 2004; 40:1260–5.

    Article  CAS  PubMed  Google Scholar 

  39. Shiffman ML, Suter F, Bacon BR, et al. Peginterferon alfa-2a and ribavirin for 16 or 24 weeks in HCV genotype 2 or 3. N Engl J Med 2007; 357:124–34.

    Article  CAS  PubMed  Google Scholar 

  40. El-Zayadi AR, Attia M, Barakat EM, et al. Response of hepatitis C genotype-4 naive patients to 24 weeks of Peg-interferon-alpha2b/ribavirin or induction-dose interferon-alpha2b/ribavirin/amantadine: a non-randomized controlled study. Am J Gastroenterol 2005; 100:2447–52.

    Article  CAS  PubMed  Google Scholar 

  41. Legrand-Abravanel F, Sandres-Saune K, Barange K, et al. Hepatitis C virus genotype 5: Epidemiological characteristics and sensitivity to combination therapy with interferon-alpha plus ribavirin. J Infect Dis 2004; 189:1397–1400.

    Article  CAS  PubMed  Google Scholar 

  42. Yuen MF, Lai CL. Response to combined interferon and ribavirin is better in patients infected with hepatitis C virus genotype 6 than genotype 1 in Hong Kong. Intervirology 2006; 49:96–8.

    Article  CAS  PubMed  Google Scholar 

  43. Poynard T, McHutchison J, Goodman Z, Ling ML, Albrecht J. Is an “A la carte” combination interferon alfa-2b plus ribavirin regimen possible for the first line treatment in patients with chronic hepatitis C? Hepatology 2000; 3:211–8.

    Article  Google Scholar 

  44. Maddrey WC. Safety of combination interferon alfa-2b / ribavirin therapy in chronic hepatitis C: relapsed and treatment-naïve patients. Semin Liver Dis 1999; 19:67–75.

    CAS  PubMed  Google Scholar 

  45. Afdhal NH, Dieterich DT, Pockros PJ, et al. Epoetin alfa maintains ribavirin dose in HCV-infected patients: a prospective, double-blind, randomized controlled study. Gastroenterology 2004; 126:1302–11.

    Article  CAS  PubMed  Google Scholar 

  46. McHutchison M, Manns M, Patel K, et al. Adherence to combination therapy enhances sustained response in genotype-1-infected patients with chronic hepatitis C. Gastroenterology 2002; 123:1061–9.

    Article  CAS  PubMed  Google Scholar 

  47. Fattovich G, Giustina G, Favarato S, Ruol A. A survey of adverse events in 11,241 patients with chronic viral hepatitis treated with alfa interferon. J Hepatol 1996; 24:38–47.

    Article  CAS  PubMed  Google Scholar 

  48. MacFarlane BM, Bridger C, Tibbs CJ, et al. Virus-induced autoimmunity in hepatitis C virus infections: A rare event. J Med Virol 1994; 42:66–72.

    Article  Google Scholar 

  49. Rocco A, Gargano S, Provenzano A, et al. Incidence of autoimmune thyroiditis in interferon-alpha treated and untreated patients with chronic hepatiti c virus infection. Neuroendocrinol Lett 2001; 22:39–44.

    CAS  PubMed  Google Scholar 

  50. Layden JE, Layden TJ. How can mathematics help us understand HCV? Gastro- enterology 2001; 120:1546–9.

    Article  CAS  PubMed  Google Scholar 

  51. Davis GL, Wong JB, McHutchison JG, Manns MP, Albrecht J. Early virologic response to treatment with pegylated interferon alfa-2b plus ribavirin in patients with chronic hepatitis C. Hepatology 2003; 38:645–52.

    Article  CAS  PubMed  Google Scholar 

  52. Marcellin P, Boyer N, Gervais A, et al. Long-term histologic improvement and loss of detectable intrahepatic HCV-RNA in patients with chronic hepatitis C and sustained response to interferon alpha therapy. Ann Intern Med 1997; 127:875–81.

    CAS  PubMed  Google Scholar 

  53. Poynard T, McHutchison J, Davis GL, Esteban_Mur R, Goodman Z, Bedossa P, Albrecht J. Impact of interferon alfa-2b and ribavirin on progression of liver fibrosis in patients with chronic hepatitis C. Hepatology. 2000; 32:1131–7.

    Article  CAS  PubMed  Google Scholar 

  54. Bruno S, Stroffolini T, Colombo M, et al. Sustained virological response to interferon-alpha is associated with improved outcome in HCV-related cirrhosis: a retrospective study. Hepatology 2007; 45:579–87.

    Article  CAS  PubMed  Google Scholar 

  55. Gross J, Johnson S, Kwo P, Afdhal N, Flamm S, Therneau T. Double-dose peginterferon alfa-2b with weight-based ribavirin improves response for interferon/ribavirin non-responders with hepatitis C: final results of “RENEW.” (abstract). Hepatology 2005; 42:219A.

    Google Scholar 

  56. Fartoux L, Degos F, Trépo C, et al. Effect of prolonged interferon therapy on the outcome of hepatitis C virus-related cirrhosis: A randomized trial. Clin Gastro Hepatol 2007; 5:502–7.

    Article  CAS  Google Scholar 

  57. DiBisceglie AM, Shiffman M, Everson GT, et al. Prolonged antiviral therapy with peginterferon to prevent complications of advanced liver disease associated with hepatitis C: Results of the Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) trial (abstract). Hepatology 2007; 46:290A.

    Google Scholar 

  58. Everson FT, Trotter J, Forman L, Kugelmas M, Halprin A, Fey B, Ray C. Treatment of advanced hepatitis C with a low accelerating dosage regimen of antiviral therapy. Hepatology 2005; 42:255–62.

    Article  CAS  PubMed  Google Scholar 

  59. Crippin JS, McCashland T, Terrault N, et al. A pilot study of the tolerability and efficacy of antiviral therapy in hepatitis C virus-infected patients awaiting liver transplantation. Liver Transpl 2002; 8:350–5.

    Article  PubMed  Google Scholar 

  60. Jeffers LJ, Cassidy W, Howell CD, Hu S, Reddy KR. Peginterferon alfa-2a (40 kd) and ribavirin for black American patients with chronic HCV genotype 1. Hepato- logy 2004; 39:1702–8.

    Article  CAS  PubMed  Google Scholar 

  61. Muir AJ, Bornstein JD, Killenberg PG. Peginterferon alfa-2b and ribavirin for the treatment of chronic hepatitis C in blacks and non-Hispanic whites. N Engl J Med 2004; 350:2265–71.

    Article  CAS  PubMed  Google Scholar 

  62. Dieterich DT, Purow JM Rajapaksa R. Activity of combination therapy with interferon alfa-2b plus ribavirin in chronic hepatitis C patients co-infected with HIV. Semin Liver Dis 1999; 19:87–94.

    CAS  PubMed  Google Scholar 

  63. Pol S, Lamorthe B, Thi NT, et al. Retrospective analysis of the impact of HIV infection and alcohol use on chronic hepatitis C in a large cohort of drug users. J Hepatol. 1998; 28:945–50.

    Article  CAS  PubMed  Google Scholar 

  64. Thomas DL, Shih JW, Alter HJ, et al. Effect of human immunodeficiency virus on hepatitis C virus infection among injecting drug users. J Infect Dis 1996; 174: 690–5.

    CAS  PubMed  Google Scholar 

  65. Eyster ME, Diamondstone LS, Lien JM, Ehmann WC, Quan S, Goedert JJ. Natural history of hepatitis C virus infection in multi-transfused hemophiliacs: Effect of co-infection with human immunodeficiency virus. J Acquir Immune Defic Syndr 1993; 6:602–10.

    CAS  PubMed  Google Scholar 

  66. Salmon-Ceron D, Lewden C, Morlat, et al. Liver disease as a major cause of death among HIV infected patients: Role of hepatitis C and B viruses and alcohol. J Hepatol 2005; 42:799–805.

    Google Scholar 

  67. Chung RT, Andersen J, Volberding P, et al. Peginterferon Alfa-2a plus ribavirin versus interferon alfa-2a plus ribavirin for chronic hepatitis C in HIV-coinfected persons. N Engl J Med 2004; 351:451–9.

    Article  CAS  PubMed  Google Scholar 

  68. Torriani FJ, Rodriguez-Torres M, Rockstroh JK, et al. Peginterferon Alfa-2a plus ribavirin for chronic hepatitis C virus infection in HIV-infected patients. N Engl J Med 2004; 351:438–50.

    Article  CAS  PubMed  Google Scholar 

  69. Carrat F, Bani-Sadr F, Pol S, et al. Pegylated interferon alfa-2b vs standard interferon alfa-2b, plus ribavirin, for chronic hepatitis C in HIV-infected patients: A randomized controlled trial. JAMA 2004; 292:2839–48.

    Article  CAS  PubMed  Google Scholar 

  70. Sulkowski MS, Thomas DL, Chaisson RE, Moore RD. Hepatotoxicity associated with antiretroviral therapy in adults infected with human immunodeficiency virus and the role of hepatitis C or B virus infection. JAMA 2000; 283:2526–7.

    Article  PubMed  Google Scholar 

  71. Poynard T, Ratziu V, McHutchison J, et al. Effect of treatment with peginterferon or interferon alfa-2b and ribavirin on steatosis in patients infected with hepatitis C. Hepatology 2003; 38:75–85.

    Article  CAS  PubMed  Google Scholar 

  72. Sanyal AJ, Chand N, Comar K, et al. Hyperinsulinemia blocks the inhibition of hepatitis C virus (HCV) replication by interferon: a potential mechanism for failure of interferon therapy in subjects with HCV and nonalcoholic fatty liver disease (abstract). Hepatology 2004; 40:179A.

    Article  Google Scholar 

  73. Bressler B, Wang K, Gries J-M, Heathcote J. Pharmacokinetics and response of obese patients with chronic hepatitis C treated with different doses of Peg-IFN alfa-2a (abstract). Hepatology 2005; 42(suppl 1):661A.

    Google Scholar 

  74. Lunel F, Musset L, Cacoub P, et al. Cryoglobulinemia in chronic liver diseases: Role of hepatitis C virus and liver damage. Gastroenterology 1994; 106: 1291–1300.

    CAS  PubMed  Google Scholar 

  75. Limaye AP, Schmidt RA, Glenny RW, Davis CL, Kowdley KV. Successful treatment of severe hepatitis C-associated pulmonary vasculitis in a liver transplant recipient. Transplantation 1998; 65:998–1000.

    Article  CAS  PubMed  Google Scholar 

  76. Zuckerman E, Keren D, Slobodin G, et al. Treatment of refractory, symptomatic, hepatitis C virus related mixed cryoglobulinemia with ribavirin and interferon-alpha. J Rheumatol 2000; 27:2172–8.

    CAS  PubMed  Google Scholar 

  77. Donada C, Crucitti A, Donadon V, et al. Interferon and ribavirin combination therapy in patients with chronic hepatitis C and mixed cryoglobulinemia (letter). Blood 1998; 92:2983–4.

    CAS  PubMed  Google Scholar 

  78. Calleja JL, Albillos A, Moreno-Otero R, et al. Sustained response to interferon-alpha or to interferon-alpha plus ribavirin in hepatitis C virus-associated symptomatic mixed cryoglobulinemia. Aliment Pharmaol Ther 1999; 13: 1179–86.

    Article  CAS  Google Scholar 

  79. Johnson RJ, Gretch DR, Yamabe H, et al. Membranoproliferative glomerulonephritis associated with hepatitis C virus infection. New Engl J Med 1993; 328:465–70.

    Article  CAS  PubMed  Google Scholar 

  80. Jefferson JA, Johnson RJ. Treatment of hepatitis C-associated glomerular disease. Semin Nephrol. 2000; 20:286–92.

    CAS  PubMed  Google Scholar 

  81. Komatsuda A, Imai H, Wakui H, et al. Clinicopathological analysis and therapy in hepatitis C virus-associated nephropathy. Intern Med 1996; 35:529–33.

    Article  CAS  PubMed  Google Scholar 

  82. Ohta S, Yokoyama H, Wada T, et al. Kobayashi K. Exacerbation of glomerulonephritis in subjects with chronic hepatitis C virus infection after interferon therapy. Am J Kidney Dis. 1999; 33:1040–8.

    Article  CAS  PubMed  Google Scholar 

  83. Davis GL. Chronic hepatitis C and liver transplantation. Rev Gastroenterol Disord. 2004; 4:7–17.

    PubMed  Google Scholar 

  84. Baid S, Tolkoff-Rubin N, Saidman S, et al. Acute humoral rejection in hepatitis C-infected renal transplant recipients receiving antiviral therapy. Am J Transplant 2003; 3:74–8.

    Article  PubMed  Google Scholar 

  85. de Latour RP, Asselah T, Levy V, et al. Treatment of chronic hepatitis C virus in allogeneic bone marrow transplant recipients. Bone Marrow Transplant 2005; 36:709–13.

    Article  Google Scholar 

  86. Jacobson IM, Gonzalez SA, Ahmed F, et al. A randomized trial of pegylated interferon alpha-2b plus ribavirin in the retreatment of chronic hepatitis C. Am J Gastroenterol 2005; 100:2453–62.

    Article  CAS  PubMed  Google Scholar 

  87. Shiffman ML, Di Bisceglie AM, Lindsay KL, et al. Peginterferon alfa-2a and ribavirin in patients with chronic hepatitis C who have failed prior treatment. Gastroenterology 2004; 126:1015–23.

    Article  CAS  PubMed  Google Scholar 

  88. Cammà C, Giunta M, Chemello L, et al. Chronic hepatitis C: Interferon retreatment of relapsers. A meta-analysis of individual patient data. Hepatology 1999; 30:801–7.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Baylor University Medical Center, Dallas, TX, USA

    Mohammad Ashfaq MD & Gary Davis MD

Authors
  1. Mohammad Ashfaq MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gary Davis MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Hepatology, Georgetown University Hospital, Reservoir Road GUH 3800, Washington, 20007, U.S.A.

    Kirti Shetty

  2. University of Connecticut Health Center, Farmington Ave. 236, Farmington, 06030-1845, U.S.A.

    George Y. Wu

Rights and permissions

Reprints and permissions

Copyright information

© 2009 Humana Press, a part of Springer Science+Business Media, LLC

About this chapter

Cite this chapter

Ashfaq, M., Davis, G. (2009). Current and Future Therapy of Chronic Hepatitis C. In: Shetty, K., Wu, G. (eds) Chronic Viral Hepatitis. Clinical Gastroenterology. Humana Press. https://doi.org/10.1007/978-1-59745-565-7_3

Download citation

  • DOI: https://doi.org/10.1007/978-1-59745-565-7_3

  • Published:

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-934115-81-7

  • Online ISBN: 978-1-59745-565-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation