Evolution of Interferon-Based Therapy for Chronic Hepatitis C

الملخص EN

Since 1986, interferon-alfa (IFN-α) monotherapy has been administered for patients with chronic hepatitis C (CHC).

However, sustained response rate is only about 8% to 9%.

Subsequent introduction of ribavirin in combination with IFN-α was a major breakthrough in the treatment of CHC.

Sustained virological responses (SVRs) rate is about 30% in hepatitis C virus genotype 1 (HCV-1) patients, and is about 65% in HCV-2 or -3 patients.

After 2000, pegylated interferon (PegIFN) much improved the rates of SVR.

Presently, PegIFN-α-ribavirin combination therapy has been current standard of care for patients infected with HCV.

In patients with HCV-1, treatment for 48 weeks is optimal, but 24 weeks of treatment is sufficient in HCV-2 or -3 infected patients.

Clinical factors have been identified as predictors for the efficacy of the IFN-based therapy.

The baseline factor most strongly predictive of an SVR is the presence of HCV-2 or -3 infections.

Rapid virological response (RVR) is the single best predictor of an SVR to PegIFN-ribavirin therapy.

If patients can't achieve a RVR but achieve a complete early virological response (cEVR), treatment with current standard of care can provide more than 90% SVR rate.

HCV-1 patients who do not achieve an EVR should discontinue the therapy.

Recent advances of protease inhibitor may contribute the development of a novel triple combination therapy.