Those who don't respond at first not helped by maintenance treatment, study shows
WEDNESDAY, Dec. 3 (HealthDay News) -- Maintenance therapy using low-dose peginterferon doesn't help patients with advanced chronic hepatitis C who haven't responded to an initial round of treatment, new research suggests.
The study also showed a surprising health decline in patients with liver disease over the course of four years.
"This course of treatment had been adopted by a number of doctors in the U.S. and in other countries, though it had yet to be proven to work. That practice should be stopped, based on the results of this trial. There is no rationale for using maintenance therapy. The treatment is clearly ineffective," study author Dr. Adrian Di Bisceglie, chief of hepatology and co-director of the Liver Center at Saint Louis University, said in a university news release.
About half of patients with chronic hepatitis C fully recover after an initial course of peginterferon and ribavirin antiviral therapy that can last from six months to a year. Other patients (non-responders) may show improvement, but the virus isn't eliminated.
The study included 1,050 non-responder patients with advanced liver disease. Half of them received low doses of peginterferon for 3.5 years to try to suppress the hepatitis C virus and slow progression of liver disease. The other patients were assigned to a control group.
After four years, 30 percent of patients in both groups had developed liver failure, liver cancer, or had died. Among those who had milder cirrhosis at the start of the study, 10 percent to 12 percent developed severe liver disease. Both of these findings surprised the researchers.
"Hepatitis patients in these circumstances got very ill over the course of four years, surprisingly so. The lesson we learned is that once chronic hepatitis C gets to the stage of advanced fibrosis, patients can decline rapidly," De Bisceglie said.
The study was published in the Dec. 4 issue of the New England Journal of Medicine.
About 4 million people in the United States are infected with hepatitis C, and 10,000 to 12,000 of them die each year. Hepatitis C is caused by virus that's transmitted through direct contact with an infected person's blood.
The U.S. Centers for Disease Control and Prevention has more about hepatitis C.
-- Robert Preidt
SOURCE: Saint Louis University, news release, Dec. 3, 2008
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