JLE

Virologie

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Treatment of hepatitis C Volume 6, issue 4, Juillet - Août 2002

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Authors
Service d'hépatologie, Inserm U. 481et Centre de recherche Claude-Bernard sur les hépatites virales, Hôpital Beaujon, 100, bd du Général-Leclerc, 92118 Clichy Cedex

Since the discovery of the hepatitis C virus in 1989, the treatment of hepatitis C has considerably improved. The combination of pegylated interferon with ribavirin gives a sustained virological response rate of about 55 %. The long-term follow-up studies showed that sustained virological response is generally associated with clinical and histological improvement and probably with a decreased risk of development of cirrhosis and hepatocellular carcinoma. The indication of therapy is mainly based on the results of the liver biopsy : treatment is indicated in patients with moderate or severe necroinflammation or fibrosis. The tolerability of combination therapy is relatively poor with a frequent flu-like syndrom and an impaired quality of life which need reduction of dosage in about 40 % and interruption of treatment in about 15 % of patients treated. The chances of obtaining a sustained virological response depends essentially on the viral genotype and the viral load. To further improve the efficacy of therapy, different new drugs are under investigation.