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July 7, 2009

Nitazoxanide: Beyond Parasites Toward a Novel Agent for Hepatitis C

"Although there is substantial literature on NTZ as a safe and effective antiparasitic agent, the initial report of its antiviral properties in HCV-infected patients came in 2008 from Rossignol et al. This study was a double-blind, placebo-controlled trial of 50 patients with HCV genotype 4 treated with NTZ monotherapy (500 mg twice daily) for 24 weeks. Remarkably, 7 of 23 patients (30%) had an end-of-treatment response and 4 of 23 (17%) had a sustained virologic response (SVR) compared with none in the placebo arm. Of note, all patients attaining an SVR had a baseline HCV RNA < 400,000 IU/mL.

"In this issue of Gastroenterology, Rossignol et al present the results of a randomized, controlled trial evaluating the efficacy of NTZ in combination with peginterferon and ribavirin. ... The authors conclude that NTZ with peginterferon and ribavirin increases RVR and SVR rates compared with standard therapy without increasing adverse events."

Read more in Gastroenterology, March, 2009.

Note: This inexpensive treatment, FDA-approved for a different use, is now being tested as an addition to standard treatment for hepatitis C genotype 1.