Patient with chronic Hepatitis C(genotype1) with high viral load, started with Pegylated Interferon Alfa 2b (80mcg) plus Ribavirin (800mg). He had a very good response, viral load became Nil after 4, 12 and 24 weeks. Now, whether we should continue IFN therapy for 48 wks?
In such a patients with G1 and RVR conventional Peg INF based treatment duration can be shorten from 48 weeks to 24 weeks
Hi
Between 24 to 36 weeks treatment duration instead of the standard 48 weeks.
Regards,
Bassem
Peg-INF plus RBV is no longer acceptable as therapy against HCV genotype 1. Harvoni or Viekirax plus Exviera should be used instead. When Peg-IFN plus RBV was used, 24 weeks was appropriate in patients with RVR if baseline HCV RNA was low (
Hello, if you have initiated dual therapy (interferon plus ribavirin) in a genotype 1 patient you should continue your therapy for 48 weeks. SVR rates of the dual therapy in genotype 1 patient is approximately %50 so if you stop therapy, HCV RNA may become positive.
Sir Dr Luis, I have around 25 cases of HepC patients, many of them of type 3 and 6, only few are of type1. For type 3 and 6, I am continuing for 24 weeks and getting very good response....
The following facts need to be remembered while treating
It is seen that Indian HCV genotype 1 patients responds much better to PEGIFN + Ribavirin than Western patients. Responses are good in treatment naive patients without cirrhosis and without other risk factors like obesity, alcoholism, NASH, coinfection with HIV/Hepatitis B. If these are absent then the present guideline says that treatment can be stopped at 24 weeks but in case of any doubt it should be continued for 48 weeks.
However since PEGIFN has serious side effects in the longrun, one can try sofosbuvir and ribavirin for 24 weeks.
Indian HCV genotype 1 patients treatment with PEGIFN + Ribavirin is 48 weeks. If it is viral load is nil at week 24, better to continue the treatment til 48 weeks then only it won't get relapse again.
Thanx Dr Raju, but if patient had RVR (Viral load after 4 wks is Nil), than what should be the duration?
Dear Dr.
We are treated one patient same as your patient. We are stopped the treatment after 24 weeks. After 6months again we checked viral load, that was detected again we are continuing the treatment.
For your patient my suggestion is better to treat 48 weeks.
That will be the better option for genotype 1 patients (if RVR also).
In your case the duration would be 48 weeks. In our country most of the patients have genotype 1 b or 1a. We have experience in antiviral therapy of this patients, and I affirm that it will be better to continue treat 1 year.
Since he had a high viral load at start of treatment he should be treated for 48 weeks.
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