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Lookup NU author(s): Professor Matthew Wright, Professor Margaret Bassendine
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Current guidelines advocate no treatment for patients with histologically mild hepatitis C virus (HCV) infection. This was a UK multicentre randomized controlled trial comparing α-interferon (3 MU thrice weekly) + ribavirin (1000-1200 mg/day) for 48 weeks with no treatment in treatment naïve, adult patients with histologically mild chronic HCV infection. The aim was to compare benefits, safety and efficacy of combination therapy with α-interferon 2b and ribavirin for 48 weeks with no treatment (current standard management) in this patient group. In the treatment group 32 of 98 (33%) patients achieved a sustained virological response (SVR). Patients infected with genotype 1 had a lower SVR than those infected with genotype non-1 (18% vs 49% P = 0.02). No patients who failed to achieve a 2-log drop in viral load at 12 weeks achieved SVR. Improvements in quality of life 24 weeks postcessation of therapy compared with baseline using the SF-36 questionnaire measures were observed in the treated group. For patients with mild HCV infection with viral genotype non-1, the results are sufficiently good to suggest that therapeutic decisions should no longer be biopsy-driven. For patients infected with genotype 1, a liver biopsy is still indicated as the low chance of SVR is outweighed by an unacceptable burden of side-effects. Patients who fail to respond by 12 weeks of therapy should have their treatment curtailed early.
Author(s): Wright M, Forton D, Main J, Goldin R, Torok E, Tedder R, Grant P, Thursz M, Naoumov N, Millson C, Mills PR, Bassendine M, Thomas HC
Publication type: Article
Publication status: Published
Journal: Journal of Viral Hepatitis
Year: 2005
Volume: 12
Issue: 1
Pages: 58-66
ISSN (print): 1352-0504
ISSN (electronic): 1365-2893
Publisher: Wiley-Blackwell Publishing Ltd.
URL: http://dx.doi.org/10.1111/j.1365-2893.2005.00575.x
DOI: 10.1111/j.1365-2893.2005.00575.x
PubMed id: 15655049
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