***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: UNLABELLED Successful treatment of chronic HCV with  peginterferon ( PEGIFN ) and ribavirin ( RVN ) is often limited by anemia . We performed the present study to determine if utilizing epoetin alpha ( EPO ) with or without a higher dose of RVN could enhance sustained virologic response ( SVR ) . We r and omized 150 treatment-naive patients with chronic HCV genotype 1 into 3 treatment groups : ( 1 ) PEGIFN alpha-2b ( 1.5 microg/kg/week ) + weight-based RVN ( WBR ) 13.3 mg/kg/day ( 800 to 1400 mg/day ) ; ( 2 ) PEGIFN alpha-2b + WBRVN + EPO ( 40,000 U/week ) ; or ( 3 ) PEGIFN alpha-2b + higher dose WBR 15.2 mg/kg/day ( 1000 to 1600 mg/day ) + EPO . We initiated EPO at the onset of therapy to maintain the hemoglobin between 12 and 15 g/dL. When required , we reduced RVN by 200-mg steps . African Americans compose 36 % of the population . A significantly smaller percentage of group 2 patients had a decline in hemoglobin to less than 10 g/dL ( 9 % versus 34 % ; P < 0.05 ) and required that the RVN dose be reduced ( 10 % versus 40 % ; P < 0.05 ) compared to group 1 patients . Despite this , SVR was similar in these groups ( 19 % to 29 % ) . SVR was significantly greater ( P < 0.05 ) in group 3 patients ( 49 % ) . This result ed from a significant decline ( P < 0.05 ) in relapse rate ; only 8 % versus 38 % for groups 1 and 2 . CONCLUSION We conclude that using EPO in all subjects at the initiation of PEGIFN and RVN treatment will not enhance SVR given the same starting dose of RVN . In contrast , a higher starting dose of RVN was associated with a lower relapse rate and higher rate of SVR BACKGROUND Patients with genotype 1 hepatitis C virus ( HCV ) who do not have a sustained response to therapy with peginterferon alfa and ribavirin  have a low likelihood of success with retreatment . METHODS We r and omly assigned patients with HCV genotype 1 who had not had a sustained virologic response after peginterferon alfa-ribavirin therapy  to one of four treatment groups : 115 patients to the T12PR24 group , receiving  telaprevir  ( 1125-mg loading dose , then 750 mg every 8 hours ) for 12 weeks and peginterferon alfa-2a ( 180 microg per week ) and ribavirin ( 1000 or 1200 mg per day , according to body weight ) for 24 weeks ; 113 patients to the T24PR48 group , receiving telaprevir for 24 weeks and peginterferon alfa-2a and ribavirin for 48 weeks ( at the same doses as in the T12PR24 group ) ; 111 patients to the T24P24 group , receiving telaprevir and peginterferon alfa-2a  for 24 weeks ( at the same doses as in the T12PR24 group ) ; and 114 patients to the PR48 ( or control ) group , receiving peginterferon alfa-2a and ribavirin for 48 weeks ( at the same doses as in the T12PR24 group ) . The primary end point was sustained virologic response ( undetectable HCV RNA levels 24 weeks after the last dose of study drugs ) . RESULTS The rates of sustained virologic response in the three telaprevir groups--51 % in the T12PR24 group , 53 % in the T24PR48 group , and 24 % in the T24P24 group -- were significantly higher than the rate in the control group ( 14 % ; P<0.001 , P<0.001 , and P=0.02 , respectively ) . Response rates were higher among patients who had previously had relapses than among nonresponders . One of the most common adverse events in the telaprevir groups was rash ( overall , occurring in 51 % of patients , with severe rash in 5 % ) . Discontinuation of study drugs because of adverse events was more frequent in the telaprevir groups than in the control group ( 15 % vs. 4 % ) . CONCLUSIONS In HCV-infected patients in whom initial peginterferon alfa and ribavirin treatment failed , retreatment with telaprevir in combination with peginterferon alfa-2a and ribavirin was more effective than retreatment with peginterferon alfa-2a and ribavirin alone . ( Clinical Trials.gov number , NCT00420784 . UNLABELLED Merimepodib ( MMPD ) is an orally administered , inosine monophosphate dehydrogenase inhibitor that has shown antiviral activity in nonresponders with chronic hepatitis C ( CHC ) when combined with pegylated interferon alfa 2a ( Peg-IFN-alfa-2a ) and ribavirin ( RBV ) . We conducted a r and omized , double-blind , multicenter , phase 2b study to evaluate the antiviral activity , safety , and tolerability of MMPD in combination with Peg-IFN-alfa-2a and RBV in patients with genotype 1 CHC who were nonresponders to prior therapy with Peg-IFN and RBV .  Patients received 50 mg MMPD , 100 mg MMPD , or placebo every 12 hours , in addition to Peg-IFN-alfa-2a and RBV , for 24 weeks . Patients with a 2-log or more decrease from baseline or undetectable hepatitis C virus ( HCV ) RNA levels at week 24 were then eligible to continue Peg-IFN-alfa-2a and RBV for a further 24 weeks , followed by 24 weeks of follow-up . The primary efficacy endpoint was sustained virological response ( SVR ) rate at week 72 in all r and omized patients who received at least one dose of study drug and had a history of nonresponse to st and ard therapy . A total of 354 patients were r and omized to treatment ( 117 to placebo ; 119 to 50 mg MMPD ; 118 to 100 mg MMPD ) , and 286 completed the core study . The proportion of patients who achieved SVR was similar among the treatment groups : 6 % ( 6/107 ) for 50 mg MMPD , 4 % ( 5/112 ) for 100 mg MMPD , and 5 % ( 5/104 ) for placebo ( P = 0.8431 ) . Adverse-event profiles for the MMPD combination groups were similar to that for Peg-IFN-alfa and RBV alone . Nausea , arthralgia , cough , dyspnea , neutropenia , and anemia were more common in patients taking MMPD . CONCLUSION The addition of MMPD to Peg-IFN-alfa-2a and RBV combination therapy did not increase the proportion of nonresponder patients with genotype 1 CHC achieving an SVR BACKGROUND In patients with chronic infection with hepatitis C virus ( HCV ) genotype 1 , treatment with peginterferon alfa and ribavirin for 48 weeks results in rates of sustained virologic response of 40 to 50 % . Telaprevir is a specific inhibitor of the HCV serine protease and could be of value in HCV treatment . METHODS A total of 334 patients who had chronic infection with HCV genotype 1 and had not been treated previously were r and omly assigned to receive one of four treatments involving various combinations of telaprevir ( 1250 mg on day 1 , then 750 mg every 8 hours ) , peginterferon alfa-2a ( 180 microg weekly ) , and ribavirin ( dose according to body weight ) . The T12PR24 group ( 81 patients ) received telaprevir , peginterferon alfa-2a , and ribavirin for 12 weeks , followed by peginterferon alfa-2a and ribavirin for 12 more weeks . The T12PR12 group ( 82 patients ) received telaprevir , peginterferon alfa-2a , and ribavirin for 12 weeks . The T12P12 group ( 78 patients ) received telaprevir and peginterferon alfa-2a without ribavirin for 12 weeks . The PR48 ( control ) group ( 82 patients ) received peginterferon alfa-2a and ribavirin for 48 weeks . The primary end point , a sustained virologic response ( an undetectable HCV RNA level 24 weeks after the end of therapy ) , was compared between the control group and the combined T12P12 and T12PR12 groups . RESULTS The rate of sustained virologic response for the T12PR12 and T12P12 groups combined was 48 % ( 77 of 160 patients ) , as compared with 46 % ( 38 of 82 ) in the PR48 ( control ) group ( P=0.89 ) . The rate was 60 % ( 49 of 82 patients ) in the T12PR12 group ( P=0.12 for the comparison with the PR48 group ) , as compared with 36 % ( 28 of 78 patients ) in the T12P12 group ( P=0.003 ; P=0.20 for the comparison with the PR48 group ) . The rate was significantly higher in the T12PR24 group ( 69 % [ 56 of 81 patients ] ) than in the PR48 group ( P=0.004 ) . The adverse events with increased frequency in the telaprevir-based groups were pruritus , rash , and anemia . CONCLUSIONS In this phase 2 study of patients infected with HCV genotype 1 who had not been treated previously , one of the three telaprevir groups had a significantly higher rate of sustained virologic response than that with st and ard therapy . Response rates were lowest with the regimen that did not include ribavirin . ( Clinical Trials.gov number , NCT00372385 . BACKGROUND / AIMS The aim of this study was to increase virologic response rates by individualized treatment according to the early virologic response . METHODS Serum HCV-RNA was frequently quantified in patients with chronic hepatitis C ( n=270 ) treated with peginterferon alfa-2a ( 180 microg/week ) and ribavirin ( 1000 - 1200 mg/day ) . After 6 weeks patients were classified as rapid ( RVR ) , slow ( SPR ) , flat ( FPR ) , or null responders ( NUR ) and r and omized within each viral kinetic class to continue therapy either with an individualized or st and ard regimen . Individualized therapy comprised peginterferon monotherapy ( 48 weeks ) or shorter combination therapy ( 24 weeks ) for RVR , triple therapy with histamine ( 1 mg/day ) ( 48 weeks ) or prolonged combination therapy ( 72 weeks ) for SPR , triple therapy for FPR , and high-dose peginterferon ( 360 microg/week ) plus ribavirin for NUR patients . RESULTS Patients were categorized as RVR ( n=171 ) , SPR ( n=65 ) , FPR ( n=10 ) , or NUR ( n=22 ) . Overall end-of-treatment and sustained virologic response rates were 77 and 60 % in the individualized and 77 and 66 % in the st and ard treatment arm , respectively . Histamine in addition to peginterferon and ribavirin and high-dose peginterferon plus ribavirin did not improve virologic response rates in patients with FPR and NUR , respectively . CONCLUSIONS An improvement in virologic efficacy was not achieved with the available individualized treatment options This study tested the hypothesis that high‐dose peginterferon alfa‐2a ( PEG‐IFNα‐2a ) for the first 12 weeks would increase early and sustained virological response ( SVR ) rates  in patients with chronic hepatitis C genotype 1 . Eight hundred ninety‐six patients were r and omized 1:1 to 360 μg ( n = 448 ) or 180 μg ( n = 448 ) PEG‐IFNα‐2a weekly plus ribavirin at 1000‐1200 mg/day for 12 weeks , followed by 36 weeks of 180 μg PEG‐IFNα‐2a weekly plus ribavirin at 1000‐1200 mg/day with 871 patients evaluable for the intention‐to‐treat  analysis . Virological responses were assessed by TaqMan ( limit of detection 15 IU/mL ) at week 4 , 8 , 12 , 24 , 48 ( end of therapy ) , and 24 weeks following therapy ( SVR ) . Undetectable hepatitis C virus RNA rates were significantly higher among patients receiving high‐dose 
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Conclusion The mortality rate during PEG-IFN/RBV therapy was acceptably low , but the rate of SAEs was not negligible in a treatment for a benign disease , and the rate was affected by treatment regimens