Heterogeneous virologic response rates to interferon-based therapy in patients with chronic hepatitis C: who responds less well?

Ann Intern Med. 2004 Mar 2;140(5):370-81. doi: 10.7326/0003-4819-140-5-200403020-00033.


The introduction of new agents and regimens for the treatment of chronic hepatitis C, such as pegylated interferons and combination therapy with ribavirin, has resulted in substantial improvements in sustained virologic response rates. However, treatment remains a challenge, particularly for certain patient populations, because several virus-related and patient-related factors are associated with a lower virologic response to therapy. Hepatitis C virus genotype 1 and a high baseline viral load are the major viral factors associated with lower response. Patient-related factors include previous relapse or nonresponse to treatment, the presence of cirrhosis, African-American ethnicity, older age, contraindications to treatment, and obesity. This article reviews the data on interferon-based therapies among patients with lower chances for sustained virologic response and discusses the potential of the new pegylated interferons.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Confounding Factors, Epidemiologic
  • Drug Therapy, Combination
  • Genotype
  • Hepacivirus / drug effects
  • Hepacivirus / genetics
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / virology
  • Humans
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use*
  • Polyethylene Glycols / therapeutic use*
  • Recombinant Proteins
  • Ribavirin / therapeutic use*
  • Treatment Failure
  • Viral Load


  • Antiviral Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • peginterferon alfa-2a