***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: Background : Interferon‐α plus ribavirin therapy for chronic hepatitis C is associated with adverse effects that lead to therapy discontinuation in up to 27 % of patients in r and omized controlled trials BACKGROUND & AIMS A phase 3 active-controlled study was conducted to assess the efficacy/safety of albinterferon alfa-2b ( albIFN ) , a novel , long-acting , genetic fusion polypeptide of recombinant human albumin and interferon alfa-2b , in patients with chronic hepatitis C virus ( HCV ) genotype 2/3 . METHODS In all , 933 patients were r and omized to open-label subcutaneous treatment with pegylated interferon-alfa-2a ( Peg-IFNalfa-2a ) 180 μg/wk , or albIFN 900 or 1200 μg every 2 weeks for 24 weeks , each administered with oral ribavirin 800 mg/day . The primary end point of the study was sustained virologic response ( SVR ) ( HCV-RNA level , < 15 IU/mL at week 48 ) . During the study , the data monitoring committee recommended dose modification for all patients receiving albIFN 1200 μg to 900 μg , impacting 38 % of this treatment arm . RESULTS By intention-to-treat analysis , SVR rates were 84.8 % ( 95 % confidence interval , 80.4%-88.6 % ) , 79.8 % ( 95 % confidence interval , 74.9%-84.1 % ) , and 80.0 % ( 95 % confidence interval , 75.1%-84.3 % ) with Peg-IFNalfa-2a , and albIFN 900 and 1200 μg , respectively . The primary hypothesis of noninferiority of SVR was established for albIFN 900 μg ( P = .009 ) and 1200 μg ( P = .006 ) . Independent positive predictors of SVR by multivariate regression analysis were pretreatment HCV-RNA level less than 400,000 IU/mL , age younger than 45 years , body mass index less than 30 kg/m(2 ) , genotype 2 , normal γ-glutamyl transpeptidase and increased alanine aminotransferase  levels at baseline , fibrosis stage F0-F2 , no steatosis , and Asian geographic region  ( Peg-IFNalfa-2a only ) . The 3 treatment groups showed similar rates of serious ( 7%-8 % ) and severe ( 13%-16 % ) adverse events , and discontinuations owing to adverse events ( 3.6%-5.5 % ) . CONCLUSION Albinterferon alfa-2b 900 μg every 2 weeks provides an alternative efficacious treatment option in patients with chronic HCV genotype 2 or 3 Background : The response rates and duration of peginterferon alpha ( PEG-IFN-α ) and ribavirin combination therapy in chronic hepatitis C genotype 4 , the prevalent genotype in the Middle East and Africa , are poorly documented . Aims : To compare the efficacy and safety of 24 , 36 , or 48 weeks of PEG-IFN-α-2b and ribavirin therapy in chronic hepatitis C genotype 4 . Methods : In this prospect i ve , r and omised , double blind study , 287 patients with chronic hepatitis C genotype 4 were r and omly assigned to PEG-IFN-α-2b ( 1.5 μg/kg ) once weekly plus daily ribavirin ( 1000–1200 mg ) for 24 weeks ( group A , n = 95 ) , 36 weeks ( group B , n = 96 ) , or 48 weeks ( group C , n = 96 ) and followed for 48 weeks after completion of treatment . Early viral kinetics and histopathological evaluation of pre- and post treatment liver biopsies were performed . The primary end point was viral clearance 48 weeks after completion of treatment . Results : Sustained virological response was achieved in 29 % , 66 % , and 69 % of patients treated with PEG-IFN-α-2b and ribavirin for 24 , 36 , and 48 weeks , respectively , by intention to treat analysis . No statistically significant difference in sustained virological response rates was detected between 36 and 48 weeks of therapy ( p = 0.3 ) . Subjects with sustained virological response showed greater antiviral efficacy ( ε ) and rapid viral load decline from baseline to treatment week 4 compared with non-responders and improvement in liver histology . The incidence of adverse events was higher in the group treated for 48 weeks . Conclusion : PEG-IFN-α-2b and ribavirin for 36 or 48 weeks was more effective in the treatment of chronic hepatitis C genotype 4 than treatment for 24 weeks . Thirty six week therapy was well tolerated and produced sustained virological and histological response rates similar to the 48 week regimen Background Nonalcoholic fatty liver disease develops in patients with chronic hepatitis C.  Interferon and ribavirin combination therapy is the st and ard treatment for chronic hepatitis C , but if present , NAFLD can reduce the virological response to anti-HCV therapies . Objectives We determined whether the addition of rosuvastatin to interferon and ribavirin improves the sustained virological response ( SVR ) and reduces steatosis . Patients and Methods This study was a prospect i ve , r and omized , open-label trial . Between January 2004 and December 2007 , 65 patients with chronic hepatitis ( 27 women and 38 men , mean age 48 years ) aged 32 - 63 years ( median 46 years ) were consecutively enrolled . Patients were r and omly assigned to receive leukocyte interferon alpha ( 3 MIU 3 times per week ) plus ribavirin ( 1200 mg per day ) for 12 months or interferon alpha and ribavirin at the same dosages plus rosuvastatin ( 5 mg per day ) . The primary endpoints were measurements in SVR , liver enzyme , cholesterol , triglyceride , CRP , glucose , and insulin levels ; and Homa-IR , fibrosis , and steatosis scores . Results After 12 months of treatment , we observed a significant improvement in SVR in 51 % of patients who received interferon plus ribavirin plus rosuvastatin compared with 18 % of relapsers ( OR 1.52 ; 95 % CI = 0.41 - 5.64 ; RR 1.13 ) . There were 23 responders ( 69 % ) and 10 nonresponders ( 30 % ) ( OR 1.38 ; 95 % CI = 0.49 - 16.5 ; RR 1.11 ) . When comparing interferon plus ribavirin group vs interferon plus ribavirin and rosuvastatin group after 12 months , we observed a significant difference in AST ( 85.70 vs.106.5.00 IU/ml ) ( OR 1.2 ; 95 % CI= 0.29 - 4.94 ; RR 1.04 ; p<0.001 ) , ALT ( 81.80 vs. 126.2 IU/ml ) ( OR 1.2 ; 95 % CI = 0.29 - 4.94 ; RR 1.04 ; p < 0.001 ) , LDL-cholesterol ( 0.01 vs. 0.60 mmol/l ) ( OR 14 ; 95 % CI = 3.98 - 49.16 ; p RR 2.96 ; < 0.001 ) , triglycerides ( 0.17 vs. 0.2 mmol/l ) ( OR 20 ; 95 % CI = 4.94 - 80.89 ; RR 5.38 ; p < 0.05 ) , and Viremia ( 1.8 vs. 2.48 UI/ml , p < 0.05 ) . Mean fibrosis score decreased 0.10 vs. 0.50 ( OR 4.5 ; 95 % CI = 0.89 - 22.66 ; RR 1.5 ; p < 0.05 ) , and mean steatosis score declined 0.30 vs. 0.50 ( OR 11.2 ; CI = 2.88 - 43.53 ; RR 2.75 ; p < 0.001 ) . Conclusions In HCV patients with NAFLD , the addition of rosuvastatin to interferon and ribavirin significantly reduces viremia , steatosis , and fibrosis without causing side effects BACKGROUND In patients with chronic infection with hepatitis C virus ( HCV ) genotype 1 who do not have a sustained response to therapy with peginterferon-ribavirin  , outcomes after retreatment are suboptimal . Boceprevir , a protease inhibitor that binds to the HCV nonstructural 3 ( NS3 ) active site , has been suggested as an additional treatment . METHODS To assess the effect of the combination of boceprevir and peginterferon-ribavirin for retreatment of patients with chronic HCV genotype 1 infection , we r and omly assigned patients ( in a 1:2:2 ratio ) to one of three groups . In all three groups , peginterferon alfa-2b and ribavirin were administered for 4 weeks ( the lead-in period ) . Subsequently , group 1 ( control group ) received placebo plus peginterferon-ribavirin for 44 weeks ; group 2 received boceprevir plus peginterferon-ribavirin for 32 weeks , and patients with a detectable HCV RNA level at week 8 received placebo plus peginterferon-ribavirin for an additional 12 weeks ; and group 3 received boceprevir plus peginterferon-ribavirin for 44 weeks . RESULTS A total of 403 patients were treated . The rate of sustained virologic response was significantly higher in the two boceprevir groups ( group 2 , 59 % ; group 3 , 66 % ) than in the control group ( 21 % , P<0.001 ) . Among patients with an undetectable HCV RNA level at week 8 , the rate of sustained virologic response was 86 % after 32 weeks of triple therapy and 88 % after 44 weeks of triple therapy . Among the 102 patients with a decrease in the HCV RNA level of less than 1 log(10 ) IU per milliliter at treatment week 4 , the rates of sustained virologic response were 0 % , 33 % , and 34 % in groups 1 , 2 , and 3 , respectively . Anemia was significantly more common in the boceprevir groups than in the control group , and erythropoietin was administered in 41 to 46 % of boceprevir-treated patients and 21 % of controls . CONCLUSIONS The addition of boceprevir to peginterferon-ribavirin result ed in significantly higher rates of sustained virologic response in previously treated patients with chronic HCV genotype 1 infection , as compared with peginterferon-ribavirin alone . ( Funded by Schering-Plough [ now Merck ] ; HCV RESPOND-2 Clinical Trials.gov number , NCT00708500 . ) BACKGROUND Cyclophilin inhibitors have shown activity against a variety of viruses , including HCV . NIM811 , a novel , non-immunosuppressive cyclophilin inhibitor was studied in ascending doses in a r and omized , double-blind , placebo-controlled 14-day trial in genotype 1 HCV patients . Doses of 10 up to 600 mg were given orally once or twice daily as monotherapy ( 9:3 r and omization of NIM811:placebo ) . 600 mg or placebo bid for 14 days was then co-administered with pegylated interferon alpha ( PEG-IFN-α ) administered on days 1 and 8 to genotype 1 relapsers . RESULTS NIM811 was well tolerated at all doses . Although lack of antiviral effect was noted in the monotherapy arms , liver transaminase normalization occurred at doses over 75 mg . Mild , clinical ly non-significant elevations of bilirubin , and significant declines in platelet numbers were observed in the 400 and 600 mg bid groups . In the combination group , the mean HCV RNA decline was 2.85 log , compared to a 0.56 log in the PEG-IFN alone arm . The mean ALT ( alanine transaminase ) declined significantly by day 14 in the combination , but was unchanged in the PEG-IFN alone group . In the combination therapy group , the mean platelets were 203 × 10(9)/L at baseline and fell to 105 × 10(9)/L by day 14 ; for patients treated with PEG-IFN the values were 177 × 10(9)/L and 139 × 10(9)/L. There was a significant increase in bilirubin , although this did not reach clinical ly concerning levels . There 
    Output:
    
RESULTS All four classes of DAA ; NS3/NS4a serine protease inhibitors , cyclophilin inhibitors , NS5b polymerase inhibitors and NS5a inhibitors , show good success rates .
Trials have been performed without ribavirin or interferon and demonstrate good antiviral activity with a decreased side effect profile .
Combinations of DAA are a promising area of research with a high success rate .
CONCLUSIONS Clinical trials show that future HCV therapy could be personalised , achieve higher success rates with decreased adverse incidents