Optimizing peginterferon and ribavirin administration in difficult-to-treat patient populations

Hepatitis C is the leading cause of liver-related US morbidity and mortality. The ultimate goal of therapy is to prevent disease complications and improve life expectancy. Effective antiviral therapy uses pegylated interferon and ribavirin. Certain populations pose a significant challenge to treatment success. The likelihood of achieving sustained virologic response rates depends on host, viral, and treatment factors, with genotype the strongest predictor. The greatest impact in optimizing drug exposure can result from targeting modifiable factors and, in some instances, from extending treatment duration or increasing standard treatment doses. Adherence to treatment duration and administration is crucial in obtaining optimal sustained virologic responses. Accurately assessing which patients may be hard to treat is of utmost importance because it facilitates setting realistic goals with the patient, which may prompt a more aggressive and multidisciplinary approach to treating these individuals. © Current Medicine Group, LLC 2009.