Service MAD et université Lille-2, Hôpital Claude-Huriez, CHRU de Lille, France
A sustained virological response (SVR) is achieved in 40% of VHC patients treated with combination of a pegylated interferon alfa and ribavirin (PEG-IFN/RBV). Duration of PEG-IFN/RBV is 6 month for genotypes 2-3 and 12 months for genotypes 1-4-5-6. A flat dose of 800 mg/day is recommended for genotypes 2-3 patients whereas weight-based dose of ribavirin need to be given to genotypes 1-4-5-6. Despite the fact that shortened treatment duration appears to be less efficient than standard duration, treating physicians may consider shortening treatment in HCV patients with a rapid viral decline when tolerance to therapy is poor. Conversely, in patients with slow viral decline, the benefit of extending therapy to 72 weeks is still controversial. Patients who developed early-onset anemia disclose higher rates of SVR. Polymorphism of interleukin IL-28B is a significant independent predictor of response to PEG-IFN/RBV and its assessment will be necessary for adapting strategy.