***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: AIM The therapy of chronic hepatitis C genotype 4 ( HCV-4 ) has not been optimized yet . This r and omized , prospect i ve , parallel-group clinical trial compared the efficacy and safety of pegylated interferon α-2a ( PEG-IFN α-2a ) plus ribavirin and PEG-IFN α-2b plus ribavirin and assessed the health-related quality of life ( HRQOL ) in patients with chronic HCV-4 . METHODS Eligible patients with proven chronic HCV-4 were r and omized to receive either a weekly dose of PEG-IFN α-2a ( 180 μg ) or PEG-IFN α-2b ( 1.5 μg/kg ) and a daily dose of ribavirin ( 1000 - 1200 mg ) for 48 weeks with 24 weeks post-treatment follow-up . The primary end point was sustained virological response ( SVR ) defined by undetectable HCV RNA 24 weeks after treatment . The Short form-36 Health Survey version 2 ( SF-36v2 ) and the Chronic Liver Disease question naires ( CLDQ ) were assessed before , during and after therapy . RESULTS The overall SVR rate of the entire cohort was 59.9 % . The SVR rates were significantly higher in patients treated with PEG-IFN α-2a and ribavirin ( Group A ; n=109 ) compared with those treated with PEG-IFN α-2b and ribavirin ( Group B ; n=108 , 70.6 vs. 54.6 % , respectively ; P=0.017 ) . The relapse rates were 5.1 % for PEG-IFN α-2a and 15.7 % for PEG-IFN α-2b ( P=0.0019 ) . The SF-36v2 and CLDQ were low during therapy and improved significantly after therapy successful therapy . CONCLUSION Pegylated interferon α-2a plus ribavirin was significantly more effective than PEG-IFN α-2b and ribavirin therapy in the treatment of chronic HCV-4 patients . The tolerability and adverse events were comparable between the two regimens . The HRQOL improved significantly after successful PEG-IFN α-2a plus ribavirin therapy BACKGROUND / AIMS As evidence accumulates relating to mother-to-child ( vertical ) transmission of hepatitis C virus ( HCV ) , it is timely to draw up guidelines for the clinical management of HCV infected pregnant women and their children . METHODS A review of evidence from the European Paediatric HCV Network ( EPHN ) prospect i ve study of HCV infected women and their children and other published studies . Meeting of EPHN clinical experts to reach a consensus on recommendations for management . Each recommendation was grade d according to the level of evidence . RESULTS / CONCLUSIONS Although several risk factors for mother-to-child transmission have been identified , none are modifiable and there are currently no interventions available to prevent vertical transmission of HCV . Data on timing of loss of maternal antibodies and reliability of diagnostic tests inform the optimum follow-up schedule for confirmation or exclusion of infection in children born to HCV infected women . Based on the current evidence , routine antenatal screening for HCV should not be introduced and neither elective caesarean section nor avoidance of breastfeeding should be recommended to HCV infected women to prevent mother-to-child transmission of HCV . HCV/HIV co-infected women should follow existing HIV guidelines Previous trials investigating the efficacy of treatment duration s shorter than the st and ard of 24 weeks for chronic hepatitis C virus ( HCV ) genotype 2/3 infections have yielded discordant results . The aims of this investigator‐initiated phase III study were to compare the efficacy of 12 or 24 weeks of treatment and to identify patients suitable for short‐term therapy . Three hundred eighty‐two genotype 2/3–infected patients [ intention‐to‐treat ( ITT ) population ] at 31 centers in Denmark , Finl and , Norway , and Sweden were r and omized to 12 or 24 weeks of peginterferon α‐2a ( 180 μg/week ) plus ribavirin ( 800 mg/day ) . Twelve weeks of therapy was inferior to 24 weeks in the ITT population ( sustained viral response [ SVR ] rates : 59 % versus 78 % , P < 0.0001 ) and in the subgroups of patients infected with genotype 2 ( 56 % versus 82 % , P = 0.006 ) or 3 ( 58 % versus 78 % , P = 0.0015 ) . These differences were observed regardless of the fibrosis stage . Age and HCV‐RNA levels on days 7 and 29 were independent predictors of SVR . Short‐term treatment was useful in patients < 40 years old , especially if HCV‐RNA was undetectable on day 29 , and also in patients ≥ 40 years old , provided that HCV‐RNA was below 1000 IU/mL on day 7 in addition to being undetectable on day 29 . If neither of these two criteria were met for patients ≥ 40 years old , 24 weeks of therapy was superior ( P < 0.0001 ) . Conclusion : Peginterferon/ribavirin treatment for 12 weeks in HCV genotype 2/3 infection is overall inferior to 24 weeks of treatment but may be useful in some patients with a rapid initial clearance of virus . ( HEPATOLOGY 2008 . BACKGROUND & AIMS Ribavirin ( RBV ) combined with either pegylated interferon ( PegIFN ) alpha2a or PegIFNalpha2b is the st and ard of care for chronic hepatitis C virus ( HCV ) infection . Due to the lack of head-to-head studies , the 2 PegIFNs have not been directly compared . The endpoints of our study were safety and antiviral efficacy of the 2 regimens . METHODS Treatment-naïve patients with chronic hepatitis C were r and omly ( 1:1 ) assigned after stratification for HCV genotype to receive either 1.5 mcg/Kg/week PegIFNalpha2b plus RBV 800 - 1200 mg/day or 180 mcg/week PegIFNalpha2a plus RBV 800 - 1200 mg/day for 24 or 48 weeks according to HCV genotype . The study was powered to detect a difference of at least 10 % in safety and efficacy of the 2 regimens . RESULTS The 212 patients on PegIFNalpha2a and the 219 patients on PegIFNalpha2b had similar baseline characteristics , including cirrhosis ( 20 % vs 18 % , respectively ) . By intention to treat , the 2 groups showed similar rates of treatment-related serious adverse events ( 1 % vs 1 % , respectively ) and drop out rates for adverse effects ( 7 % vs 6 % , respectively ) . Overall , sustained virologic response ( SVR ) rate was higher in PegIFNalpha2a than in PegIFNalpha2b patients ( 66 % vs 54 % , respectively , P = .02 ) , being 48 % vs 32 % in the 222 HCV-1 and -4 patients ( P = .04 ) , and 96 % vs 82 % , respectively , in the 143 HCV-2 patients ( P = .01 ) . PegIFNalpha2a independently predicted SVR in the logistic regression analysis ( odds ratio , 1.88 ; 95 % confidence interval : 1.20 - 2.96 ) . CONCLUSIONS Although the 2 regimens showed a similar safety profile , the PegIFNalpha2a-based treatment yielded significantly more SVR than PegIFNalpha2b BACKGROUND & AIMS There is increasing interest in identifying patients with chronic hepatitis C genotype 2 or 3 infection in whom it is possible to lower the burden of therapy while retaining high levels of efficacy . METHODS Treatment-naive patients with chronic hepatitis C genotype 2/3 infection were r and omized to receive peginterferon alfa-2b ( 1.5μg/kg/wk ) for 24weeks ( group A ) ; peginterferon alfa-2b ( 1.0μg/kg/wk ) for 24weeks ( group B ) ; or peginterferon alfa-2b ( 1.5μg/kg/wk ) for 16weeks ( group C ) , each in combination with weight-based ribavirin ( 800 - 1200mg/d ) . The study population comprised two cohorts : the Hep-Net cohort enrolled in Germany and an International cohort enrolled at study sites throughout Europe and Asia . The primary end point was sustained virological response ( SVR ) . RESULTS The study included 682 patients ; 80.2 % had genotype 3 infection . In the intent-to-treat population , SVR rates were 66.5 % , 64.3 % , and 56.6 % in groups A , B , and C , and were similar in Asian and white patients . Treatment differences ( A vs. B and A vs. C ) failed to reach the predefined margin for noninferiority of -10 % ; and thus groups B and C failed to show noninferiority relative to group A. Among patients with undetectable HCV RNA at week 4 , SVR rates were 75.3 % , 75.9 % , and 72.4 % , respectively . Relapse rates were 17.8 % , 16.3 % , and 29.3 % , respectively . Treatment-emergent serious adverse events were highest in group A and lowest in group C , and adverse events leading to discontinuation were similar across treatment arms . CONCLUSIONS For patients with chronic hepatitis C genotype 2/3 infection , 24weeks of peginterferon alfa-2b ( 1.5μg/kg/wk ) plus weight-based ribavirin remains a st and ard-of-care therapy ; however , treatment for 16weeks may be considered for patients with undetectable HCV RNA at week 4 of the treatment BACKGROUND Patients with chronic hepatitis C virus ( HCV ) infection who have not had a response to therapy with peginterferon and ribavirin  may benefit from the addition of multiple direct-acting antiviral agents to their treatment regimen . METHODS This open-label , phase 2a study included an exploratory cohort of 21 patients with chronic HCV genotype 1 infection who had not had a response to previous therapy ( i.e. , had not had ≥2 log(10 ) decline in HCV RNA after ≥12 weeks of treatment with peginterferon and ribavirin ) . We r and omly assigned patients to receive the NS5A replication complex inhibitor daclatasvir ( 60 mg once daily ) and the NS3 protease inhibitor asunaprevir ( 600 mg twice daily ) alone ( group A , 11 patients ) or in combination with peginterferon alfa-2a and ribavirin ( group B , 10 patients ) for 24 weeks . The primary end point was the percentage of patients with a sustained virologic response 12 weeks after the end of the treatment period . RESULTS A total of 4 patients in group A ( 36 % ; 2 of 9 with HCV genotype 1a and 2 of 2 with genotype 1b ) had a sustained virologic response at 12 weeks after treatment and also at 24 weeks after treatment .. Six patients ( all with HCV genotype 1a ) had viral breakthrough while receiving therapy , and resistance mutations to both antiviral agents were found in all cases ; 1 patient had a viral response at the end of treatment but had a relapse after the treatment period . All 10 patients in group B had a sustained virologic response at 12 weeks after treatment , and 9 had a sustained virologic response at 24 weeks after treatment . Diarrhea was the most common adverse event in both groups . Six patients had transient elevations of alanine aminotransferase levels to more than 3 times the upper limit of the normal range . CONCLUSIONS This preliminary study involving patients with HCV genotype 1 infection who had not had a response to prior therapy showed that a sustained virologic response can be achieved with two direct-acting antiviral agents only . In addition , a high rate of sustained virologic response was achieved when the two direct-acting antiviral agents were combined with peginterferon alfa-2a and ribavirin . ( Funded by Bristol-Myers Squibb ; Clinical Trials.gov number , NCT01012895 . ) AIM To evaluate the significance of induction with high doses of pegylated interferon -2b ( Peg-IFNalpha-2b ) and the predictability of sustained virologic response ( SVR ) in naïve patients with chronic hepatitis C. METHODS 188 consecutive naïve patients with chronic hepatitis C were enrolled in a r and omised controlled clinical trial . Patients were r and omised to receive either Peg-IFN -2b 3.0 mcg/kg QW x 12 weeks followed by 1.5 mcg/kg QW x 36 weeks plus 800 - 1200 mg ribavirin ( Arm A ) or Peg-IFNalpha-2b 1.5 mcg/kg QW x 48 weeks plus 800 - 1200 mg ribavirin ( Arm B ) . HCV-RNA was obtained at 
    Output:
    
Compared with dual therapy , boceprevir triple therapy increased risk for hematologic adverse events and telaprevir triple therapy increased risk for anemia and rash .
A large well- design ed cohort study and 18 smaller cohort studies found that an SVR after antiviral therapy was associated with lower risk for all-cause mortality than was no SVR .
SVR rates for genotype 1 infection are higher with triple therapy that includes a protease inhibitor than with st and ard dual therapy .
An SVR after antiviral therapy appears associated with improved clinical outcomes .