***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 Gastrointestinal haemorrhage from ruptured esophageal varices ( EV ) is a significant cause of morbidity and mortality in patients with HCV-related cirrhosis . The risk of developing EV and bleeding is influenced by hepatitis severity , which can be attenuated by successful interferon ( IFN ) therapy . Our aim was to prospect ively assess whether a successful IFN therapy modifies development and /or progression of EV in patients with HCV-related compensated cirrhosis . METHODS Child-Pugh A patients with either no or small ( F1 ) EV underwent surveillance with repeated endoscopy during and after completion of IFN-based therapy . RESULTS A total of 127 patients ( 59 years , 79 males , 65 HCV-1/4 and 17 F1 EV ) received weight-based ribavirin ( RBV ) combined with either IFN-α2b 3 MU three times per week ( n=36 ) , weekly pegylated (PEG)-IFN-α2b 1.5 μg/kg ( n=68 ) or weekly PEG-IFN-α2a 180 μg ( n=23 ) . Patients were followed-up for 18 - 108 months after treatment completion with a median endoscopic follow-up of 68 months for the 62 patients with a sustained virological response ( SVR ) and 57 months for the 65 non-SVR patients ( P=0.3 ) . De novo EV developed in 10 ( 9.1 % ) patients including 2/57 SVR and 8/53 non-SVR ( 3.5 % versus 15.1 % ; P=0.047 ) , whereas EV progressed in size in 3 patients , including 1/5 SVR and 2/12 non-SVR ( P=0.87 ) . Two non-SVR patients bled from EV and one died . CONCLUSIONS A successful IFN therapy prevents or delays the de novo onset of EV in patients with compensated cirrhosis due to HCV , but does not abrogate the need for continued endoscopic surveillance BACKGROUND Pegylated interferon ( peginterferon ) alfa 2a or 2b plus ribavirin regimens were the st and ard of care in patients with hepatitis C virus ( HCV ) infection , but the sustained virological response can be suboptimum in patients with HCV genotype 1 infection . The efficacy , safety , and tolerability of the combination of simeprevir , a one-pill , once-daily , oral HCV NS3/4A protease inhibitor versus placebo , plus peginterferon alfa 2a or 2b plus ribavirin was assessed in treatment-naive patients with HCV genotype 1 infection . METHODS In the QUEST-2 , phase 3 study , done at 76 sites in 14 countries ( Europe , and North and South Americas ) , patients with confirmed chronic HCV genotype 1 infection and no history of HCV treatment were r and omly assigned with a computer-generated allocation sequence in a ratio of 2:1 and stratified by HCV genotype 1 subtype and host IL28B genotype to receive simeprevir ( 150 mg once daily , orally ) , peginterferon alfa 2a ( 180 μg once weekly , subcutaneous injection ) or 2b ( according to bodyweight ; 50 μg , 80 μg , 100 μg , 120 μg , or 150 μg once weekly , subcutaneous injection ) , plus ribavirin ( 1000 - 1200 mg/day or 800 - 1400 mg/day , orally ; simeprevir group ) or placebo ( once daily , orally ) , peginterferon alfa 2a or 2b , plus ribavirin ( placebo group ) for 12 weeks , followed by just peginterferon alfa 2a or 2b plus ribavirin . Total treatment duration was 24 weeks or 48 weeks ( simeprevir group ) based on criteria for response-guided therapy ( ie , HCV RNA < 25 IU/mL undetectable or detectable at week 4 and undetectable week 12 ) or 48 weeks ( placebo ) . Patients , study personnel , and the sponsor were masked to treatment assignment . The primary efficacy endpoint was sustained virological response at 12 weeks after the planned end of treatment ( SVR12 ) . Analyses were by intention to treat . The trial is registered with Clinical Trials.gov , number NCT01290679 . Results from the primary ( SVR12 , week 60 ) analysis are presented . FINDINGS 209 ( 81 % ) of 257 patients in the simeprevir group and 67 ( 50 % ) of 134 in the placebo group had SVR12 ( adjusted difference 32·2 % , 95 % CI 23·3 - 41·2 ; p<0·0001 ) . The incidences of adverse events were similar in the simeprevir and placebo groups at 12 weeks ( 246 [ 96 % ] vs 130 [ 97 % ] ) and for the entire treatment ( 249 [ 97 % ] vs 132 [ 99 % ] ) , irrespective of the peginterferon alfa used . The most common adverse events were headache , fatigue , pyrexia , and influenza-like illness at 12 weeks ( 95 [ 37 % ) vs 45 [ 34 % ] , 89 [ 35 % ] vs 52 [ 39 % ] , 78 [ 30 % ] vs 48 [ 36 % ] , and 66 [ 26 % ] vs 34 [ 25 % ] , respectively ) and for the entire treatment ( 100 [ 39 % ] vs 49 [ 37 % ] , 94 [ 37 % ] vs 56 [ 42 % ] , 79 [ 31 % ] vs 53 [ 40 % ] , and 66 [ 26 % ] vs 35 [ 26 % ] , respectively ) . Rash and photosensitivity frequencies were higher in the simeprevir group than in the placebo group ( 61 [ 24 % ] vs 15 [ 11 % ] and ten [ 4 % ] vs one [ < 1 % ] , respectively ) . There was no difference in the prevalence of anaemia between the simeprevir and placebo groups ( 35 [ 14 % ] vs 21 [ 16 % ] , respectively , at 12 weeks , and 53 [ 21 % ] vs 37 [ 28 % ] , respectively , during the entire treatment ) . INTERPRETATION Addition of simeprevir to either peginterferon alfa 2a or peginterferon alfa 2b plus ribavirin improved SVR in treatment-naive patients with HCV genotype 1 infection , without worsening the known adverse events associated with peginterferon alfa plus ribavirin . FUNDING Janssen Infectious Diseases-Diagnostics BACKGROUND / AIMS Peginterferon alfa-2a plus ribavirin improves sustained virological responses compared with interferon alfa-2b and ribavirin , or peginterferon alfa-2a alone in chronic hepatitis C. We examined the impact of these treatments on health related quality of life ( HRQOL ) . METHODS Patients ( n=1121 ) were r and omized to peginterferon alfa-2a weekly plus ribavirin or placebo , or interferon alfa-2b thrice weekly plus ribavirin .  HRQOL was assessed with the SF-36 Health Survey and Fatigue Severity Scale ( FSS ) . RESULTS Patients receiving peginterferon alfa-2a plus ribavirin reported better HRQOL than those receiving interferon alfa-2b plus ribavirin . These differences were statistically significant for three SF-36 domains and both FSS scores ( p<=0.05 ) . Patients receiving peginterferon alfa-2a plus placebo had the least impairment ; adding ribavirin significantly decreased five domains of the SF-36 and both FSS scores . Sustained virological response was associated with improvement at follow-up on all SF-36 and FSS scores . CONCLUSIONS The effects of combination therapy on HRQOL and fatigue are less with peginterferon alfa-2a plus ribavirin than interferon alfa-2b plus ribavirin . Each medication in combination therapy with interferon and ribavirin , affects patients ' quality of life differently . Underst and ing the relationship of specific therapeutic options to HRQOL may help physicians minimize the impact of therapy on HRQOL BACKGROUND & AIMS Chronic hepatitis C is both a virologic and fibrotic disease and complications can occur in patients with sustained virologic response ( SVR ) with residual fibrosis . Due to the limitations of repeated biopsies , no studies have assessed the dynamic of fibrosis before and after treatment . Using biopsy as reference , FibroTest ™ has been vali date d as a biomarker of fibrosis progression and regression , with similar prognostic values . The aim was to estimate the impact of SVR on the dynamic of fibrosis presumed by FibroTest ™ . METHODS In a prospect i ve cohort , the main end point was the 10-year regression rate of fibrosis , defined as a minimum 0.20 decrease in FibroTest ™ , equivalent to one METAVIR stage . RESULTS A total of 933 patients with both repeated FibroTest ™ and transient elastography were included . At 10 years , among the 415 patients with baseline advanced fibrosis , 49 % ( 95 % CI 33 - 64 % ) of the 108 SVR had a regression , which was greater than in the 219 non-responders [ 23 % ( 14 - 33 % ; p < 0.001 vs. SVR ) ] and not lower than in the 88 non-treated [ 45 % ( 10 - 80 % ; p = 0.39 vs. SVR ) ] patients . In all 171 SVR , cirrhosis regressed in 24/43 patients , but 15 new cirrhosis cases occurred out of 128 patients , that is only a net reduction of 5.3 % [ ( 24 - 15 ) = 9/171 ) ; ( 2.4 - 9.8 % ) ] . Four cases of primary liver cancer occurred in SVR [ 4.6 % ( 0 - 9.8 ) ] , and 13 in non-responders [ 5.6 % ( 1.5 - 9.8 ) ; p = 0.07 ] . CONCLUSIONS In patients with chronic hepatitis C , and as presumed by FibroTest ™ , virological cure was associated with slow regression of fibrosis 10years later , a disappointing 5 % decrease in cirrhosis cases , and a remaining 5 % risk of primary liver cancer BACKGROUND Although the addition of the HCV NS3/4A protease inhibitors boceprevir and telaprevir to pegylated interferon ( peginterferon ) alfa plus ribavirin has improved sustained virological response ( SVR ) in treatment-naive and treatment-experienced patients infected with hepatitis C virus ( HCV ) genotype 1 , the regimens have a high pill burden and are associated with increased rates and severity of adverse events , such as anaemia and rash . The efficacy and safety of the combination of simeprevir , a one pill , once-daily , oral HCV NS3/4A protease inhibitor , plus peginterferon alfa 2a plus ribavirin were assessed in treatment-naive patients with HCV genotype 1 infection . METHODS In QUEST-1 , a phase 3 , r and omised , double-blind multicentre trial undertaken in 13 countries ( Australia , Europe , North America , Puerto Rico , and New Zeal and ) , 394 patients ( aged ≥18 years ) with chronic HCV genotype 1 infection and no history of HCV treatment , stratified by HCV subtype and host IL28B genotype , were r and omly assigned in a 2:1 ratio with a computer-generated allocation sequence to receive simeprevir ( 150 mg once daily , orally ) plus peginterferon alfa 2a plus ribavirin for 12 weeks , followed by peginterferon alfa 2a plus ribavirin ( simeprevir group ) , or placebo orally plus peginterferon alfa 2a plus ribavirin for 12 weeks , followed by peginterferon alfa 2a plus ribavirin ( placebo group ) . Treatment duration was 24 weeks or 48 weeks in the simeprevir group according to criteria for response-guided therapy ( ie , HCV RNA < 25 IU/mL [ undetectable or detectable ] at week 4 and < 25 IU/mL undetectable at week 12 ) and 48 weeks in the placebo group . Patients , study personnel , and the sponsor were masked to the treatment group assignment . The primary efficacy endpoint was sustained virological response 12 weeks after the planned end of treatment ( SVR12 ) and was assessed with an intention-to-treat analysis . The results of the primary analysis ( week 60 ) are presented for safety and SVR12 . This trial is registered 
    Output:
    
Patients who achieve SVR also have health state utility values that are 0.05 to 0.31 higher than non-responders to treatment .
Achievement of SVR has implication s beyond those of clearing viral infection ; it is associated with improved long-term clinical outcomes , economic benefits and improved health-related quality of life