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Is a new treatment possible?
Oct 24, 2001

Im a swedish nurse with Hepatit C and Im a non responder to both monoterapy with Interferon and combination terapy with Peg-Interferon and Ribaverin. When I got the combination terapy I got a lot of exaemas after 9 month so my doctor stoped the treatment. When I checked the virus titres a few month later I just had about 4 miljon copies per ml and before the treatment I had 18 milion copies. Do you think the terapy should have helped me to kill all the virus if I had got it for 18 months and do you think its possible to try again? I have virus genotype 1 and I have probably had it for about 20 years. Biopsis showes bad activity for my liver (5 years ago stadium 1 and last year stadium 4). I should be very glad if you can give me an answer, my doctor have no answer on this. /Anki

Response from Dr. Rodriguez-Torres

I assume that you had treatment with Peg-Intron and Ribavirin.When you started treatment with Peg,you had less chance of response because your genotype 1,high viral load ,non-responder status and the severity of liver disease.The available data suggests that less than 20% of cases will respond with 48 weeks of treatment,in that setting. The data with Pegasys, Pegylated interferon alfa 2a,is better in cirrhotics ,than Peg-Intron,as well as in genotype 1.There is evidence also, that response may be increased, with longer duration of therapy, in difficult to treat patients as non responders. I agree that with the PCR decrease you had during therapy,I would probably recommend you to continue treatment. You have to consider another trial of therapy, with Pegasys and RBV(better tolerated);and probably use the drugs for 18 months ,if you are a responder at week 48.That will be your best chance for sustained response.Although the data is not out,I would also add Amantadine to the combination.The drug is very safe ,and on going studies suggest that it adds to the Pegasys regimens,findings that differ from the other interferons. Beyond that ,all is in early research.Good luck!!



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