Inside, during a meal, at a dose of 800-1400 mg per day, divided into two stages (morning and evening). Simultaneously assigned interferon alpha-2b by subcutaneous injections 3 times per week for 3 million or peginterferon alfa-2b proviron cycle subcutaneously at a dose of 1.5 g per 1 kg body weight once a week.
Patients infected with HCV genotype 1: the emergence of sustained virological response with continued treatment is highly unlikely, if after 12 weeks of treatment, elimination of viral RNA from serum is not observed. Patients with virologic response after 12 weeks of treatment, the treatment should be continued even during the 9 months. (total duration of treatment – 48 weeks). In patients with low viral load (not higher than 600,000 IU / ml), in which after 4 weeks of treatment, there was elimination of RNA of the virus and thereafter it was not detected – up to 24 weeks of treatment, the treatment after 24 weeks can be discontinued (the total length of the course – 24 weeks), or continued for another 24 weeks (total duration of the course – 48 weeks). Note, however, that the risk of relapse after 24 weeks of treatment than after 48 weeks of treatment.
Patients infected with HCV genotype 2 or 3: The recommended duration of treatment for all patients in this group – 24 weeks, except for patients with HCV / HIV co-infection, which should be treated for 48 weeks.
Patients infected with HCV genotype 4: generally proviron cycle noted that this group of patients to achieve sustained virologic response is unlikely. Duration of therapy should be the same as for patients infected with genotype 1.
Repeat courses of therapy in patients who do not respond to the initial course of therapy,
the recommended duration of treatment is 48 weeks, regardless of HCV genotype.
Estimating the probability of response to treatment in patients with recurrent disease who receive repeated courses of therapy
- Early virologic response (reduction in viral load by at least 2 log (100 times), or elimination of after 12 weeks) to predict achieving SVR. For patients with relapsed after prior treatment course (with non-pegylated and pegylated interferon), achieved early virologic response at week 12 of therapy, was 59% and 50%, respectively. Patients with genotype 1 or 4 virus, treatment-naïve non-pegylated interferon achieved early virologic response at 12 weeks re-treatment course, rates reached 51%. In patients with a reduction in viral load> 2 log (more than 100 times), but determined by the level at 12 weeks of therapy, the frequency of achieving sustained virologic response is approximately 6%. At the same time, patients with a lack of virologic response (with detectable viral load at week 12 of therapy) who received previous therapy with pegylated interferon, are less likely to achieve a sustained response than patients who had received prior therapy with non-pegylated interferon in combination with ribavirin (12% vs. 29%).
- undetectable viral load at week 12 of therapy is typical for 36% of patients. In this group of patients the frequency of achieving sustained virological response was 56%.
- patients who did not achieve an early virological response at week 12 of therapy, have a very low chance of achieving a sustained virologic response. Such patients should consider the proviron cycle termination of the current course of therapy with peginterferon alfa-2b and ribavirin therapy, and change tactics.
Patients with chronic hepatitis C infected with HIV: the recommended duration of treatment is 48 weeks, regardless of genotype.
Estimating the probability of response in patients with co-infection
early virologic response (reduction of at least 2 log (100-fold) elimination of the viral load or viral RNA after 12 weeks) to predict a sustained virologic response.
Situations in which you might need to adjust the dosing regimen
After 6 months of therapy, the patient should undertake a survey to identify virologic response. In the absence of virologic response should decide to terminate the combination therapy with proviron cycleand interferon alfa-2b or peginterferon alfa-2b.
In the event of serious adverse events or laboratory abnormalities during the