Heterogeneous Virologic Response Rates to Interferon-Based Therapy in Patients with Chronic Hepatitis C: Who Responds Less Well?

  1. Stefan Zeuzem, MD
  1. From Saarland University Hospital, Homburg/Saar, Germany.

    Abstract

    The introduction of new agents and regimens for the treatment of chronic hepatitis C, such as pegylated interferons and combination therapy with ribavirin, has resulted in substantial improvements in sustained virologic response rates. However, treatment remains a challenge, particularly for certain patient populations, because several virus-related and patient-related factors are associated with a lower virologic response to therapy. Hepatitis C virus genotype 1 and a high baseline viral load are the major viral factors associated with lower response. Patient-related factors include previous relapse or nonresponse to treatment, the presence of cirrhosis, African-American ethnicity, older age, contraindications to treatment, and obesity. This article reviews the data on interferon-based therapies among patients with lower chances for sustained virologic response and discusses the potential of the new pegylated interferons.

    Article and Author Information

    • Acknowledgments: The author thanks Karen Schneider and Michael von Wagner, MD, for administrative and research assistance with this manuscript.

    • Grant Support: By the Commission of the European Communities, Specific Research and Technological Development Program Quality of Life and Management of Living Resources (grants QLK2-CT-2000-00836 and QLK2-CT-2002-00954) and by the Bundesministerium für Bildung und Forschung Program Kompetenznetz Hepatitis (grants 01KI0102 7 and 12.2).

    • Potential Financial Conflicts of Interest:Consultancies, Honoraria, and Grants received: Hoffmann La-Roche, Schering-Plough, Yamanouchi. Dr. Zeuzem has served as a member of international advisory boards and speakers' bureau and as a clinical investigator for Hoffmann La-Roche, Schering Plough, and Yamanouchi.

    • Requests for Single Reprints: Stefan Zeuzem, MD, Department of Internal Medicine II, Saarland University Hospital, Kirrberger Strasse, 66421 Homburg/Saar, Germany; e-mail, Zeuzem{at}uniklinik-saarland.de.

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    This Article

    1. Ann Intern Med March 2, 2004 vol. 140 no. 5 370-381
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