News from Hepatitis Week of July 13, 2003 / Vol. 3 No. 18

Study: Healthier Hepatitis C Patients May Want to Pass Up Combo Therapy


People with hepatitis C who are otherwise healthy with minimal evidence of liver damage may be better off passing up combination therapy with pegylated interferon, which is effective in at most 60 percent of patients and can produce severe side effects, according to Harvard researchers.

The recommended 48-week combination treatment -- injections of interferon and oral ingestion of ribavarin -- has been shown to lengthen the lives of hepatitis C sufferers with existing liver damage.

But a majority of hepatitis C patients do not develop liver damage before ultimately dying of other causes so the drug treatment may not be cost-effective or helpful, the researchers reported in the Journal of the American Medical Association.

The researchers said the probability of patients with chronic hepatitis C developing cirrhosis over a 30-year period ranged from 13 percent tro 46 for men and from 1 to 29 for women.

"For patients at low risk of progressing, the overall health gain from treatment may be minimal given the potential for toxic side effects," said Sue Goldie, author of the report.

"There has been a huge effort over the last few years to identify people infected with (hepatitis C), but this wider group of patients will likely include those who are least likely to develop advanced liver disease," Goldie said.

"While newer treatment options for hepatitis C appear to be reasonably cost-effective on average, these results vary widely across different patient subgroups and depend critically on quality-of-life assumptions," the researchers concluded.

"As the pool of persons eligible for treatment for hepatitis C infection expands to the more general population, it will be imperative for patients and their physicians to consider these assumptions in making individual-level treatment decisions," the researchers said.

Other sources:Journal of the American Medical Association