What is the optimal duration of therapy in patients with hepatitis C genotype 2 or 3 infection ? : a review

Pegylated interferon plus ribavirin is the standard treatment for chronic hepatitis C (HCV). Even if genotype 2 and 3 patients only request a treatment of 24 weeks, this treatment remains very costly and difficult to tolerate due to numerous side effects. Recently several studies focused on the possibility of further reducing treatment duration in chronic HCV genotype 2 and 3 patients without compromising sustained virological response (SVR). Based on the available data, patients presenting a negative PCR at week 4 named a rapid virological response (RVR) probably are the best candidates to benefit from shorter treatment duration. In contrast patients without RVR should at least be treated for 24 weeks and retrospective data suggest that a more intensive or prolonged therapy for 48 weeks could be necessary. However, at this moment it remains impossible to propose general recommendations for all patients with genotype 2 and 3. Therefore more randomized prospective trials are needed to clarify several issues that are discussed in this review article. (Acta gastroenterol. belg., 2008, 71, 298-302).