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Combined Drug Therapy May Be Required to Treat Hepatitis C

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Raymond S. Koff, MD, from the division of digestive diseases and nutrition at the University of Massachusetts department of medicine, is the author of an editorial accompanying the study. In it, he writes that the benefits of retreating individuals for hepatitis C when they had not responded to previous interferon therapy will remain unclear until better treatments are discovered. In the meantime, however, patients who are given a second treatment are probably best off if they are given interferon in combination with ribavirin. The study and editorial are published in the Jan. 10 issue of the Journal of the American Medical Association.

Liver expert Michael Cox, MD, FACP, FACG, tells WebMD that the decision about whether to treat hepatitis C viral infections is not always clear-cut because therapy is extremely expensive, and those with only mild cases of the disease are less likely to have severe liver problems and to respond well to treatment. However, Cox believes emphatically that everyone with hepatitis C should be treated.

"If I had this virus, I would try to get rid of it, even if I had very mild disease," he says. "[E]ven if we don't cure [patients,] we give them what we think is a significant advantage. [Treatment] slows down the virus and can even reverse some of the damage done to the liver already." Cox is assistant chief of gastroenterology at Mercy Medical Center in Baltimore.

All the experts agree that response rates with currently available medications for the treatment of hepatitis C are not adequate and that the clearest message offered from this study is that more research into the development of new and better therapies is essential.

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