Individually Adapted Therapy Duration for the Treatment of Chronic Hepatitis C Genotype 1 Infection
Individually Adapted Therapy Duration for the Treatment of Chronic Hepatitis C Genotype 1 Infection
Patients with chronic hepatitis C genotype 1 virus infection are usually treated with
 Interferon alfa plus Ribavirin over 48 weeks. For some patients this might be too long, for
 others too short. An individually adapted therapy length from 24 to 72 weeks will be
 determined in dependence of the initial virus load and the time to HCV RNA negativity.

 The primary objective is to compare the cumulative rate of the sustained viral response (SVR)
 of the patients with the individually adapted therapy duration to the SVR rates of a historic
 patient collective under the 48 week standard therapy.
Further objectives of this trial are:

 To record the tolerance of the therapy with Peginterferon alfa-2b plus Ribavirin over 72
 weeks inclusive the adverse reactions and the withdrawal rates.

 To evaluate the biochemical response to the treatment (ALT values during and after the
 therapy) in comparison to the virological response to the treatment.

 To evaluate the validity of the withdrawal rules of this trial at week 12 and 24 in
 comparison to the 2-log-rule and a qualitative detection of the HCV RNA at week 24 with a
 detection limit of 50 IU/ml.

 To evaluate the impact of the HCV RNA concentration before the therapy, and the HCV kinetic
 during the therapy on the response to the treatment in the different groups.

 To evaluate the impact of the serum concentration of Ribavirin on anaemia and the virological
 therapy response, as well as the dependence of the serum concentration of Ribavirin on the
 creatinine clearance in comparison to the body weight.
Inclusion Criteria:

 -  Patients with a chronic HCV infection (HCV antibodies and HCV RNA positive)

 -  Presence of a HCV genotype 1 infection

 -  Presence of a compensated liver disease satisfying following hematological and
 biochemical minimum criteria: - Hemoglobin value >= 13 g/dl in men, >= 12 g/dl in
 women - Leukocytes >= 3.000/mm3 or neutrophile granulocytes > 1.500/mm3 - Thrombocytes
 > 80.000/mm3

 -  Total bilirubin in the normal range

 -  Albumin in the normal range

 -  Serum creatinine in the normal range THS in the normal range

 -  Exclusion of an autoimmune hepatitis

 -  Alpha-Fetoprotein in the normal range

 -  Negative HIV test

 -  Negativity of Hepatitis B surface antigens (Hbs-Ag)

 -  Normal or elevated ALT/GTP values at screening

 -  At known diabetes mellitus or hypertension an ophthalmologic examination must be
 performed

 -  Liver biopsy within the last 12 months must confirm the diagnoses of a chronic
 hepatitis

 -  A confirmation must be given that sexually active patients practice a save method of
 contraception during the therapy and 6 (women) to 7 (men) months after the therapy

 Exclusion Criteria:

 -  Age < 18 years, > 70 years

 -  Previous treatment of hepatitis c with (Peg)Interferon alfa or (Peg)Interferon
 alfa/Ribavirin

 -  Patients with organ transplantations other than cornea or hair

 -  Infection with HCV genotype 2,3,4,5 or 6

 -  Pregnant or nursing women

 -  Any other reason for the liver disease than chronic hepatitis C

 -  Suspected hypersensitivity to Interferon, Peginterferon or Ribavirin

 -  Participation in a clinical trial or treatment with an investigational product 30 days
 before inclusion in this study

 -  Patients with any kind of hemoglobinopathy

 -  Documented liver disease in advanced state Liver cirrhosis Child B and C

 -  Each known and existing clinical conditions that might challenge the participation or
 completion of this clinical trial as depressions, psychosis, severe psychiatric
 diseases, suicide ideations CNS traumata or cramps which need medicamentous treatment

 -  Relevant cardiovascular dysfunctions in the last 6 months or patients with clinically
 relevant changes in the ECG

 -  Insufficiently adjusted diabetes mellitus

 -  Severe chronic lung diseases (as e.g. COPD)

 -  Immunologic diseases or autoimmune-diseases or any other disease which demand a
 longtime treatment with corticosteroids during this clinical trial

 -  Clinically relevant gout

 -  Abuse of drugs, alcohol or pharmaceuticals

 -  Patient with clinically relevant changes of the retina

 -  Missing ability or willingness to understand the purpose of this study or to give a
 written consent for participating in this study.