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Managing chronic hepatitis C in the difficult-to-treat patient

Nyingi Kemmer1, Guy W Neff

  • 1Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0595, USA.

Liver International : Official Journal of the International Association for the Study of the Liver
|November 27, 2007
PubMed

Insights

Managing chronic hepatitis C virus (HCV) infection is challenging, especially for non-responders. This review covers risk factors and management strategies for difficult-to-treat HCV patients, including retreatment options.

Area of Science:

  • Hepatology
  • Virology
  • Gastroenterology

Background:

  • Chronic hepatitis C virus (HCV) infection presents management challenges, particularly with complications like cirrhosis and liver failure.
  • Current pegylated interferon (peg-IFN) plus ribavirin therapy achieves viral eradication in only about 50% of patients, with many experiencing non-response or relapse.
  • Identifying factors influencing treatment response is crucial for optimizing outcomes in difficult-to-treat HCV patients.

Purpose of the Study:

  • To review risk factors associated with resistance to hepatitis C virus (HCV) treatment.
  • To discuss the assessment and management strategies for patients with chronic HCV who are resistant to therapy.
  • To explore retreatment options for patients who have failed initial HCV treatment.

Main Methods:

  • Review of existing literature on HCV treatment resistance.
  • Analysis of factors influencing response to interferon-based therapies.
  • Evaluation of retreatment strategies including pegylated interferon and consensus interferon.

Main Results:

  • Several viral, hepatic, and patient-related factors influence response to interferon therapy.
  • Early identification of risk factors and viral load can predict treatment response.
  • Retreatment with peg-IFN and consensus IFN shows efficacy in non-responders and relapsers, though optimal duration is undetermined.

Conclusions:

  • Effective management of treatment-resistant chronic hepatitis C virus (HCV) requires understanding risk factors and utilizing available retreatment options.
  • Early assessment and potential modification or discontinuation of treatment are key for non-responders.
  • Further research is needed to determine optimal retreatment durations and the role of maintenance therapy for chronic hepatitis C virus (HCV).

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