DOCTOR'S VIEWS ARCHIVE


Topic: Hepatitis C, June 2000

Dr. Lee:
I have a viewer who underwent six months of treatment with interferon alone. After the treatment his hepatitis C RNA  test initially dropped and now is back at high levels again. What can we offer this patient who has developed disease relapse after treatment?

Dr. Edward Block:
Since he was initially treated with a single agent (interferon), he could be re-treated with combination treatment (interferon with ribavirin). We can hope for re-treatment success (long-term eradication of virus) rate of up to 30 to 40% with this combination.

Dr. Lee:
If we can achieve sustained eradication of virus for six months after completing treatment, are these patients considered cured forever?

Dr. Edward Block:
Well, we are a little reluctant to use the term "cured" at this time, since we have only a few years of data available.

But I believe that if one is disease-free (meaning that you have no detectable virus as measured by HCV RNA blood test) at six months following treatment completion, you are essentially cured.

We now have data that goes out 5 to 6 years. The recurrence rate of Hepatitis C in patients who are free of the virus at six months after treatment is extremely low (may be 1% or 2 %). So for the majority (more than 95%) of patients successfully treated, they can consider themselves essentially cured.

Dr. Lee:
Another viewer has undergone six months of combination therapy with interferon injections with ribavirin. This viewer also experienced a relapse several months after cessation of treatment. What would you do now?

Dr. Edward Block:
This is a more difficult patient to treat. If the patient had been treated with only six months of combination treatment and had a favorable response initially and then relapsed, then it would be reasonable to consider re-treating this patient for up to a year.