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Authors


  • Potential conflict of interest: Nothing to report.

We appreciate Dahari and Cotler's interest in our findings. We agree that viral kinetics during the lead-in phase with peg-interferon-α/ribavirin (PEG/RBV) may enable individualization and prediction of a minimum therapy duration to effect a sustained virological response (SVR); we likewise agree that further studies would be necessary to confirm this approach.

We believe that Wang, Pfeiffer, and Morgan missed the point of our analysis regarding the interleukin (IL)−28B genotype. We do not dispute that relative to the non-CC subtype, CC conferred an advantage in terms of higher SVR rates (CC 97% and 97% versus non-CC 78% and 76% in double and triple therapy arms, respectively); however, in genotype 1-infected patients with low viral load at baseline who achieve aviremia at week 4 with PEG/RBV, there was no benefit in adding boceprevir, regardless of a patient's IL28B subtype. Although patients with the unfavorable subtype respond less well to therapy, for those patients with low viral load and RVR after lead-in with PEG/RBV there is still no advantage of adding a protease inhibitor.

  • Brian L. Pearlman, M.D.1Carole M. Ehleben, Ph.D.2

  • 1Center for Hepatitis C, Atlanta Medical Center Medical College of Georgia Emory School of Medicine Atlanta, GA

  • 2Department of Graduate Medical Education Atlanta Medical Center Atlanta, GA

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