Hepatitis C Management

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What is the expected rate of recurrence for a 40-year-old female patient whose viral load has dropped from 457,000 IU/mL to less than detectable during the first 3 months of interferon/ribavirin therapy? She cannot tolerate side effects.

Sustained virologic response (SVR) after 12 weeks of treatment is unlikely, but it is also genotype and patient dependent. It is very difficult to provide an estimate for this patient, but you may be able to make an estimate based on genotype. Recent studies suggest that patients with genotypes 2 and 3 who achieve a rapid virologic response (RVR), defined as undetectable RNA at 4 weeks, have a very good chance of obtaining an SVR with 14 to 16 weeks of therapy. This is rarely adequate therapy for a genotype 1 patient, but patients with genotype 1, low viral load, and RVR may still have an excellent response with 24 weeks of therapy.

For more information, see the section on treatment in the Hepatitis C Management monograph.

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