Hepatitis C: Who Should You Treat and How?

Abstract

At present the treatment of hepatitis C virus infection (HCV) has improved because of combined treatment with interferon (IFN) and ribavirin. The association of these two drugs has obtained a positive response in 40–50% of naive patients treated. Patients with relapse after monotherapy with IFN also show positive response with combined treatment in up to about 50% of patients with HCV genotype 1b. In patients with other genotypes the response is higher (up to 70%). In nonresponders to IFN alone, the response to combined therapy was higher although there is scarce data reporting this. Similar results were achieved in cirrhotic patients. The use of pegylated IFN has shown even greater efficacy. Sustained response was greater than 50%. Lastly, triple therapy with IFN, ribavirin and amantadine has been studied in small clinical trials in nonresponders to IFN monotherapy, with controversial results since in some studies sustained response was up to 48% being less than 20% in other studies.

Predictors of Psychopathological Outcome During Peg-Interferon and Ribavirin Therapy in Patients with Chronic HCV-Correlated Hepatitis

“…According to the study of Dieperink and others (2000), in fact, patients with pre-existing psychiatric disorders may expect their symptoms to worsen during antiviral treatment. In a previous study, moreover, the degree of depression during antiviral therapy was significantly correlated with the severity of depressive symptoms at the beginning of treatment (Sánchez Tapias and Rodés 2002). The presence of depression was found to reduce the compliance to antiviral therapy, and the baseline level of depression predicted the possible aggravation of these symptoms during treatment.…”