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Managing chronic hepatitis C in relapsers and non-responders
M Montalbano1, N Kemmer, G W Neff
1ISMETT Mediterranean Institute for Transplantation and Advanced Specialized Therapies, UPMC Italy, Palermo, Italy.
Minerva Gastroenterologica E Dietologica
|February 27, 2008
Summary
Chronic hepatitis C virus (HCV) infection presents challenges, with many patients not responding to standard pegylated interferon (peg-IFN) therapy. This review explores risk factors for treatment resistance and strategies for managing difficult-to-treat HCV patients.
Area of Science:
- Hepatology
- Virology
- Internal Medicine
Background:
- Chronic hepatitis C virus (HCV) infection leads to severe complications like cirrhosis and liver failure.
- Current pegylated interferon (peg-IFN) plus ribavirin therapy achieves sustained virologic response in only about 50% of patients.
- A significant portion of patients are non-responders or relapsers to standard HCV treatment.
Purpose of the Study:
- To review risk factors associated with treatment resistance in chronic hepatitis C virus (HCV) infection.
- To discuss the assessment and management strategies for patients with difficult-to-treat HCV.
- To explore emerging treatment options for non-responders and relapsers.
Main Methods:
- Review of existing literature on HCV treatment resistance.
- Analysis of viral, hepatic, and patient-related factors influencing treatment outcomes.
- Discussion of retreatment strategies including peg-IFN and consensus IFN.
Main Results:
- Several factors influence response to IFN therapy, with many being unmodifiable.
- Early identification of risk factors and viral load monitoring can predict treatment response.
- Retreatment with peg-IFN and consensus IFN shows efficacy in non-responders and relapsers.
Conclusions:
- Managing difficult-to-treat HCV patients requires understanding resistance factors and exploring alternative therapies.
- Extended duration of retreatment may be necessary for optimal outcomes.
- Protease inhibitors represent a promising future direction for HCV treatment.
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