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For Hepatitis C, 48-Week Ribavirin Treatment Works Best

Reduced dosing in selected patients may not affect outcome success

MONDAY, Oct. 30 (HealthDay News) -- Most patients with genotype 1 hepatitis C who respond to ribavirin have the best outcomes with a complete 48-week treatment, but baseline viral load and age may select patients who could stop or lower the dose without jeopardizing outcomes, according to a report in the October issue of Gastroenterology.

Jean-Pierre Bronowicki, M.D., of the University Hospital Nancy in Vandoeuvre-les-Nancy, France, and colleagues treated 516 patients with genotype 1 hepatitis C with pegylated interferon alfa and ribavirin of 800 mg/day. At week 24, 70 percent were RNA negative and were randomized to continue combination therapy or have only pegylated interferon.

Although their quality of life and side effects improved, responders who stopped ribavirin at 24 weeks had significantly more breakthroughs during and relapses after treatment (68.2 percent) than those who continued (52.8 percent). Lower baseline viral load and younger age in the pegylated interferon group were linked with success in stopping ribavirin therapy at week 24 without losing sustained virologic response.

"First, ribavirin primarily acts by sustaining the virologic response to pegylated interferon alfa," the authors write. "Second, ribavirin must be administered for the full treatment duration in most genotype 1-infected patients who respond; third, baseline parameters may help identify patients who could discontinue ribavirin or reduce the dose without losing their chance of success."

The study was supported by a grant from Roche Laboratories, France.

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