Prolonged Therapy of Advanced Chronic Hepatitis C with Low-Dose Peginterferon

• Published in: The New England journal of medicine Vol. 359; no. 23; pp. 2429 - 2441
• Main Authors: Di Bisceglie, Adrian M, Shiffman, Mitchell L, Everson, Gregory T, Lindsay, Karen L, Everhart, James E, Wright, Elizabeth C, Lee, William M, Lok, Anna S, Bonkovsky, Herbert L, Morgan, Timothy R, Ghany, Marc G, Morishima, Chihiro, Snow, Kristin K, Dienstag, Jules L
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 04.12.2008
• Subjects: Alanine Transaminase - blood; Antiviral Agents - administration & dosage; Antiviral Agents - adverse effects; Antiviral Agents - therapeutic use; Biological and medical sciences; Carcinoma, Hepatocellular - etiology; Disease Progression; Drug Administration Schedule; Drug therapy; Female; General aspects; Hepacivirus - genetics; Hepacivirus - isolation & purification; Hepatitis; Hepatitis C, Chronic - blood; Hepatitis C, Chronic - drug therapy; Hepatitis C, Chronic - mortality; Hepatitis C, Chronic - pathology; Human viral diseases; Humans; Infectious diseases; Interferon; Interferon-alpha - administration & dosage; Interferon-alpha - adverse effects; Interferon-alpha - therapeutic use; Kaplan-Meier Estimate; Liver - pathology; Liver cirrhosis; Liver Cirrhosis - drug therapy; Liver Cirrhosis - pathology; Liver Cirrhosis - virology; Liver Neoplasms - etiology; Male; Medical sciences; Middle Aged; Proportional Hazards Models; Recombinant Proteins; RNA, Viral - blood; Treatment Outcome; Viral diseases; Viral hepatitis; Infection; Medicine; Treatment; Viral disease; Low dose; Digestive diseases; Hepatic disease; Advanced stage; Viral hepatitis C; Prolonged
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMoa0707615

Patients with chronic hepatitis C who did not have a sustained viral response to peginterferon and ribavirin were randomly assigned to receive low-dose peginterferon or no treatment for 3.5 years. The clinical and histologic outcomes were not better in patients treated with peginterferon. These findings do not support the use of long-term peginterferon in patients who do not have a sustained virologic response to initial therapy. Patients with chronic hepatitis C who did not have a sustained viral response to peginterferon and ribavirin were randomly assigned to receive low-dose peginterferon or no treatment for 3.5 years. The clinical and histologic outcomes were not better in patients treated with peginterferon. More than 3 million Americans and 170 million persons worldwide are chronically infected with hepatitis C virus (HCV), 1 , 2 which can result in progressive hepatic injury and fibrosis, culminating in cirrhosis and end-stage liver disease. 3 Among adults in the Western world, chronic hepatitis C is a major cause of cirrhosis and a major indication for liver transplantation. Chronic hepatitis C has contributed also to the increasing incidence of hepatocellular carcinoma, for which few satisfactory therapies exist. 4 Therapy with peginterferon and ribavirin for 24 to 48 weeks leads to a sustained loss of serum HCV RNA (termed a sustained virologic response), . . .