Treatment of hepatitis C : impact on the virus, quality of life and the natural history

Results of treatment for chronic hepatitis C have improved sub- stantially during the last decade. Combination treatment with interferon alpha 3 MU tiw and ribavirin 1000-1200 mg daily dur- ing 24 to 48 weeks leads to sustained virologic response (SVR) in approximately 40% of patients, two to three times more than interferon alpha monotherapy. It was considered standard thera- py at the EASL Consensus Conference of February 1999. Recently, results have been published on treatment with pegylated interferons alone and in combination with ribavirin. Pegylated interferon treatment leads to almost doubling of SVR rate as com- pared with standard interferon monotherapy. Combination of pegylated interferon alpha with ribavirin is most promising, lead- ing to a SVR rate of 54 to 56%. It is to be expected that this treat- ment will become the new standard. Selected patients with geno- type 2 or 3 have now a SVR rate of almost 80%. Response to treat- ment also leads to significant improvement of quality of life and survival, probably by reducing the risk of developing hepatocellu- lar carcinoma. Recent data suggest that early interferon alpha treatment of patients with acute hepatitis C largely prevents thde- velopment of chronicity. (Acta gastroenterol. belg., 2002, 65, 90-94).