Maintenance Therapy for Hepatitis C Not Helpful, Says Study

What happens if you are treated for chronic hepatitis C, but don't respond to the medication? A common medical practice is for you to start "maintenance therapy," which is a half dose of pegylated interferon (90 micrograms) for up to 4 years. However, a new study provides evidence that patients with chronic hepatitis C are not benefiting from this type of therapy.

"Before this study, many physicians had assumed that maintenance therapy was beneficial and had used this approach for their patients," said Adrian M. Di Bisceglie, MD, one of the study's researchers. "We had hoped that maintenance therapy would prevent the progression of liver disease due to hepatitis C among patients who had not responded to conventional therapy. Of course, [according to the study's results] things did not turn out that way."

The study, recently published in the New England Journal of Medicine, followed over one thousand hepatitis C patients who didn't respond to a first round of treatment for 3.5 years. The results did not support what many doctors believed. In fact, it showed that maintenance therapy with peginterferon did nothing to stop the progression of fibrosis, which is liver scarring that leads to cirrhosis and other complications.

What does this mean for the many who are using maintenance therapy? It might lead your physician to stop using it and focus on another therapy. "Right now," says Dr. Di Bisceglie, "we are looking to the development of new drugs, such as protease inhibitors (like Telapravir and Bocepravir) and polymerase inhibitors (still in early development) to offer the next big advance in management of hepatitis C." Of course, it's very important that you talk with your physician before discontinuing any treatment. Don't make this decision by yourself! Remember, this is just one study and doctors choose treatment regimens very carefully. However, this study may change how many doctors think about this type of treatment. For patients who don't reach sustained virologic response after initial treatment, doctors will need to look for better treatments.

For now, efforts must focus on prevention and early diagnosis. "Early diagnosis is important," says Dr. Di Bisceglie. "We urge persons at risk of hepatitis C to get a blood test from their doctor." Think you're at risk for hepatitis C? Learn how to protect yourself from infection.