TY - JOUR A1 - Reddy, K. Rajender A1 - Nelson, David R. A1 - Zeuzem, Stefan T1 - Ribavirin: current role in the optimal clinical management of chronic hepatitis C T2 - Journal of hepatology N2 - Ribavirin in combination with peginterferon alfa shows strong clinical efficacy against chronic hepatitis C, and is now established as the standard of care. However, the precise role of ribavirin is still being defined, suggesting that optimal ribavirin dose should be maintained over the whole treatment period. Ribavirin dosage varies by bodyweight for genotype 1 disease (1000 mg/day in patients ⩽75 kg and 1200 mg/day in patients >75 kg), whereas 800 mg/day is sufficient to ensure optimal response in all genotype 2/3 patients. Similarly, genotype 1 patients benefit from 48 weeks of therapy, while 24 weeks is sufficient for genotype 2/3 disease. Recent data suggest treatment success is dependent on cumulative ribavirin exposure, as patients who receive <60% of the planned dose have lower response rates, regardless of whether reductions are from temporary interruptions or premature cessation of therapy. All patients should be monitored for hemolytic anemia, as early diagnosis allows management through small dose reductions and stepwise return to the target dose, maximizing cumulative exposure. Despite these recent advances in our knowledge, many questions remain, such as whether the role of ribavirin will change or even be eliminated as new therapies are developed. KW - Ribavirin KW - Chronic hepatitis C KW - Sustained virological response Y1 - 2008 UR - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/76468 UR - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-764686 SN - 0168-8278 VL - 50.2009 IS - 2 SP - 402 EP - 411 PB - Elsevier CY - Amsterdam ER -