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April/May 2010 (vol. 06/6)
Hepatitis C meta-analysis
A meta-analysis found high rates of spontaneous clearance of hepatitis C virus in patients with acute infection. Anti-viral treatment should be delayed for 12 weeks to allow for this. Of the 22 studies meeting inclusion criteria, 16 were treatment studies (five randomised controlled trials). The clearance rate for untreated patients was 55.1%, and the average time from the onset of symptoms to spontaneous clearance was 9.7 weeks. For patients undergoing antiviral treatment – mostly peginterferon monotherapy or combination therapy – the overall sustained virological response rate (SVR = no detectable virus for six months after completing treatment) was 78%; significantly higher than the untreated rate. Viral clearance decreased if treatment was delayed: for treatment within 12 weeks of diagnosis, SVR = 82.5%; 66.9% for treatment at 12–24 weeks; and 62.5% for treatment beyond 24 weeks.
Journal of Viral Hepatitis 2010; 17: 201–207.http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2009.01167.x/abstract
Occupational Health at Work April/May 2010 (vol. 06/6) pp48