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  • Potential conflict of interest: Nothing to report.

Reply:

We thank Drs. Huang and colleagues1 for the comments regarding the impact of the optimal ribavirin dose for treatment of chronic hepatitis C, genotype 2/3. We fully agree that length of treatment and the dose of ribavirin are interrelated. In response to an earlier comment to our study,2 we discussed this aspect already. Furthermore, we provided additional data that the outcome of treatment was independent of the individual ribavirin dose/kg body weight. In our article,3 we did not recommend a reduction of ribavirin for every patient but have shown that the decrease in hemoglobin levels was lower in patients in the 400 mg/day group. Thus, in patients with the risk of anemia, it is possible to lower the dose of ribavirin without losing efficacy, as long as they are treated for 24 weeks. The ACCELERATE trial demonstrated convincingly that an abbreviated 16-week regimen of peginterferon alfa-2a plus ribavirin 800 mg/day is less effective than a 24-week regimen.4 Whether shortening of treatment in a selected group of patients is cost effective remains to be studied.

Peter Ferenci*, * Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.

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