| [ Summary ] |
In cirrhotic patients with genotype 1b hepatitis C viral infection, the sustained virological response (SVR) has been shown to be 67 % with interferon-free double direct acting antivirals (DAAs) in combination with ribavirin. However, SVR rates were shown to be lower without ribavirin. In patients with genotype 2 or 3 infections, sofosbuvir and ribavirin combination treatment induced high SVR rates if the patients were treated for 12 to 16 weeks. However, SVR rates was lower in patients with cirrhosis than those without cirrhosis. When patients with genotype 1b infectious cirrhosis were treated with telaprevir, peginteerferon and ribavirin triple combination therapy, SVR rates were shown tobe as low as 29 to 53 %. Serious adverse events such as sepsis and endocarditis were frequently observed. These results were reported at the EASL meeting in 2013. When cirrhotic patients with genotype 1 infections were treated with a combination of simeprevir, peginterferon and ribavirin, SVR rates were reported to be as high as 58 to 64.7 % at the same EASL meeting. The SVR rate was 27.0 to 27.9 % when cirrhotic patients with genotype 1b hepatitis C viral infection were treated by peginterferon alpha-2a and ribavirin for 48 weeks in Japan. In Western countries, maintenance peginterferon alpha-2a administration has been shown to reduce the incidence of hepatocellular carcinoma. |