Categories: Hepatitis C

March 2009 Volume 5, Issue 3 , 9

John G. McHutchison, MD, Sammy Saab, MD, MPH, and Tuesdae R. Stainbrook, DO, MPH

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The treatment of hepatitis C has improved dramatically since the first trials of interferon monotherapy 20 years ago—first with the addition of ribavirin to interferon, then with the introduction of pegylated interferon. Although interferon plus ribavirin remains the standard treatment for hepatitis C, the past 5 years have seen refinements in the regimen with the use of weight-based ribavirin and alternative ribavirin dosing and therapy duration for difficult-to-treat patient populations. With these developments, the proportion of patients attaining a sustained virologic response has increased from 8–10% with interferon monotherapy to more than 40% with peginterferon plus weight-based ribavirin. Studies over the past several years have shown that adherence to the planned treatment regimen, particularly with respect to ribavirin, is important for maximizing response to treatment. Therefore, steps to increase adherence, including more convenient dosing, proper management of side effects, and patient education, should increase the likelihood of attaining a sustained virologic response, with the ultimate goals of reducing disease progression and preventing further liver damage.