Treatment for hepatitis C is aimed at eliminating the virus and thus preventing the development of cirrhosis. The effectiveness of antiviral therapy with pegylated interferon and ribavirin is based upon inhibition of viral replication and successful viral clearance while maintaining minimal toxicity. Therapy as short as 12 to 16 weeks duration may be adequate for those with genotypes 2 or 3, and 24 weeks may be sufficient for those with genotype 1 and low viral load who achieve rapid virologic response. On the other hand, extension of therapy beyond 48 weeks may be necessary for those with genotype 1 and slow response or those with a high pretreatment viral load who do not achieve rapid virologic response. As new viral kinetic data emerge with pegylated interferon and ribavirin, the tailoring of hepatitis C virus treatment will allow shorter durations of therapy for some patients and a greater chance of sustained response in others who are treated for longer durations.
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