AIM:To use existing hepatitis C virus(HCV)antiviral therapies as access to new treatments is limited.METHODS:A Pub Med search for randomised control trials or meta-analysis related to response-guided therapy of HCV genotype 1 patients was undertaken using pegylated interferon and ribavirin(PR),boceprevir(B)and telaprevir(T)and lead-in where responseguided therapy at TW4(TW4),8(TW8),10(TW10),or12(TW12)based on HCVRNA(+)or HCVRNA(-).Studies presented at major conferences were also used.Where necessary,a post-hoc analysis was performed.A response-guided management roadmap was created based on sustained virological response(SVR).RESULTS:Starting with PR,those with HCVRNA(-)at TW4 have>86%SVR,while those are HCVRNA(+)have 34%-41.7%SVR.HCVRNA(-)TW4 patients can have 24 wk PR if HCVRNA80%SVR,leading to the"80-80"rule.CONCLUSION:Using a roadmap based on HCVRNA(-)at TW4 or TW8(the"80-80"rule),high SVR can be achieved,and guide the best choices for treatment,and also reduces drug exposure in poor responders.
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