| Theme |
An Update on Hepatitis C Treatment |
| Title |
Combination Therapy with Interferon and Ribavirin; Treatment Strategy for Improvement of Sustained Response Rate |
| Author |
Naoki Hiramatsu |
Department of Gastroenterology, Osaka University School of Medicine |
| Author |
Norio Hayashi |
Department of Gastroenterology, Osaka University School of Medicine |
| [ Summary ] |
Combinated interferon and ribavirin therapy has expanded the horizons for anti-viral therapy to the treatment of chronic hepatitis C. It has been shown to increase sustained virological response (SVR) two-fold compared with interferon monotherapy, when administered for six months. However, the SVR rate for patients with Genotype 1 and high viral loads is still about 20%. To increase the SVR rate, it is very important that the very high reappearence rate of HCV RNA (70~80%) after the end of 24 weeks of combination-therapy is reduced. The reappearence rate after treatment is closely related to the timing of HCV RNA disappearence during treatment, and HCV RNA reappeared in almost all patients whose HCV RNA disappeared from their sera after twelve weeks of treatment. Although the longer duration of combination therapy with interferon and ribavirin is most effective in suppressing HCV RNA reappearance after 24 weeks of therapy, 24 week combination-therapy followed by 24 week interferon monotherapy is thought to be the best therapy in Japan for suppressing the reappearence of HCV RNA, leading to SVR. |