Individualisierte Behandlung der chronischen Hepatitis C

Abstract

Patients infected with HCV genotype 1 are treated with a pegylated interferon plus ribavirin for 48 weeks, while HCV-2 or 3 infected patients are treated for 24 weeks. Knowledge of the HCV genotype and fibrosis stage together with baseline viremia and the initial virologic response to therapy enables further individualization of the treatment duration. Non-cirrhotic patients with HCV-1 infection, a baseline viremia < 600,000 U/ml and a rapid virologic response (< 50 U/ml at week 4) can achieve a sustained virologic response rate of almost 90% with only 24 weeks of combination therapy. HCV-2 and HCV-3 infected patients with low baseline viremia can be treated for less than 24 weeks without compromising sustained virologic response rates. A longer treatment duration of up to 72 weeks appears reasonable for HCV-1 infected patients with serum HCV RNA levels of 50-6,000 U/ml at week 12 of therapy.