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Peginterferon alfa plus ribavirin is currently the treatment of choice for chronic hepatitis CPeginterferon alfa-2a40KDplus ribavirin has given an overall sustained virological response of 18in F3/F4 previous nonresponder US patientsWe evaluated the effectiveness of peginterferon alfa-2a40KDplus ribavirin in Brazilian patients who were relapsers or nonresponders to previous interferon-based therapyOne-hundred-thirty-four patients with biopsy-proven chronic hepatitis CHCV RNA positiveelevated ALT and who were either relapsersn=37or nonrespondersn=97to at least 24 weeks of conventional interferon/ribavirin therapy were retreated with peginterferon alfa-2a40KD180mg/qw and ribavirin 800mg bid for 48 weeksEfficacy was assessed as virological responsedefined as undetectable HCV RNAat the end of treatmentEoTand at the end of follow-upSVRSustained Virological ResponseSafety assessments consisted of clinical and laboratory evaluationsIn the patient sample72were genotype 1 and 34were cirrhoticIn an intention-to-treat analysisrelapser patients showed 78EoT response and 51SVRNonresponders showed 57EoT response and 26SVRPositive predictive factors of SVR were non-1 genotype and relapser stateSix percent of the patients interrupted treatment because of adverse events and 45had dose reductionmainly associated with leucopenia and anemiaBrazilian patient relapsers and nonresponders to conventional interferon and ribavirin treatment can achieve a sustained virological response when retreated with peginterferon alfa-2a40KDand ribavirinThe safety profile is similar to that of naive patients.

It is not known whether ribavirin passes into breast milk or if it could harm a nursing babyYou should not breast-feed while you are taking ribavirin.

Before treatment startspatients should talk to their doctor about all their health conditionsincluding if they:

In both studiesvirus genotype was clearly the strongest predictor of whether or not a patient achieved a sustained virological response.

In both studiesvirus genotype was clearly the strongest predictor of whether or not a patient achieved a sustained virological response.

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