Which patients with genotype 1 chronic hepatitis C can benefit from prolonged treatment with the ‘accordion’ regimen?  Patrick Marcellin, E. Jenny Heathcote, Antonio Craxì  Journal of Hepatology  Volume 47, Issue 4, Pages 580-587 (October 2007) DOI: 10.1016/j.jhep.2007.07.015 Copyright © 2007 European Association for the Study of the Liver Terms and Conditions

Fig. 1 Sustained virological response rates in treatment-naïve genotype 1 patients receiving 48 weeks of therapy with peginterferon alfa-2a (40kDa) plus ribavirin 1000 or 1200mg/day in a large, randomised, multicentre study [2]. A low HCV RNA level was defined as ⩽800,000IU/mL. Journal of Hepatology 2007 47, 580-587DOI: (10.1016/j.jhep.2007.07.015) Copyright © 2007 European Association for the Study of the Liver Terms and Conditions

Fig. 2 Range of possible virological responses in patients with chronic hepatitis C treated with the combination of pegylated interferon plus ribavirin. Journal of Hepatology 2007 47, 580-587DOI: (10.1016/j.jhep.2007.07.015) Copyright © 2007 European Association for the Study of the Liver Terms and Conditions

Fig. 3 The ‘accordion’ effect. The time required for HCV RNA clearance affects the overall duration of therapy needed to obtain SVR. Based on data from several prospective studies [4,13,18,19,39,40]. Journal of Hepatology 2007 47, 580-587DOI: (10.1016/j.jhep.2007.07.015) Copyright © 2007 European Association for the Study of the Liver Terms and Conditions

Fig. 4 Frequency of virological relapse rates in patients with rapid and slow virological responses at weeks 4 and 12. Patients in group A were treated for 48 weeks and patients in group B were treated for 72 weeks with peginterferon alfa-2a (40kDa) 180μg/week plus ribavirin 800mg/day in a large, randomised, multicentre study. Journal of Hepatology 2007 47, 580-587DOI: (10.1016/j.jhep.2007.07.015) Copyright © 2007 European Association for the Study of the Liver Terms and Conditions

Fig. 5 Sustained virological response rates and virological relapse rates in patients randomised to 48 or 72 weeks of therapy with peginterferon alfa-2a (40kDa) plus ribavirin 800mg/day. Only patients who were HCV RNA detectable (>50IU/mL) at week 4 were randomised [19]. Journal of Hepatology 2007 47, 580-587DOI: (10.1016/j.jhep.2007.07.015) Copyright © 2007 European Association for the Study of the Liver Terms and Conditions

Fig. 6 Proposed algorithm for the selection of genotype 1 patients for extended treatment based on published data [12,18,19]. Journal of Hepatology 2007 47, 580-587DOI: (10.1016/j.jhep.2007.07.015) Copyright © 2007 European Association for the Study of the Liver Terms and Conditions