Some patients with hepatitis C can halve the duration of treatment
Nearly two thirds of people with the easier-to-treat forms of chronic hepatitis C may be able to halve the duration of their antiviral treatment from 24 weeks to 12 weeks, according to research presented last month at the annual meeting of the European
Association for the Study of the Liver in Berlin.
A randomised controlled trial of 283 chronic hepatitis C patients with
genotype 2 or 3 disease showed that those clear of virus after four weeks
of treatment with peginterferon alfa-2b and ribavirin do just as well
with 12 weeks’ as with 24 weeks’ treatment. Of those clear
after four weeks, 85 per cent achieved a sustained viral response with
12 weeks’ treatment, compared with 89 per cent of those on the
longer course. The short course had a slightly higher relapse rate, but
fewer patients dropped out because of adverse events. Early viral clearance
at week 4 might serve as a useful indicator to decide the length of treatment,
explained Alessandra Mangia, from IRCSS-CSS Hospital, San Giovanni Rotondo,
Italy.
In another presentation, Thierry Poynard, from Pitié-Salpetrière
Hospital, Paris, told participants that prompt treatment for common adverse
events associated with peginterferon/ribavirin treatment, such as anaemia,
fatigue and depressive disorders, can improve adherence to hepatitis
C treatment. He recommended greater use of epoetin alfa for anaemia in
the early weeks of treatment, and of selective serotonin reuptake inhibitor
antidepressants during weeks 4 to 12 of treatment when depression is
most common. |
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