Retreatment of chronic hepatitis C virus infection in patients who failed to achieve sustained virologic response.

The treatment of patients with chronic hepatitis C virus (HCV) has improved dramatically over the past several years. Despite this nearly half of all patients fail to achieve a sustained virologic response (SVR) following therapy. The decision to retreat a non-responder depends upon several factors which include data regarding the response to the previous course of therapy and the likelihood that a favorable response can be achieved with retreatment. These factors must be balanced against the risk for fibrosis progression and developing cirrhosis in each individual patient before a decision is made for embark upon retreament. The management of patients who have failed to achieve SVR is therefore one of the most complicated in the spectrum of treating chronic HCV. This manuscript will review the factors to consider when assessing such patients, the likelihood of achieving an SVR with current therapy and options for patients who continue to manifest non-response.