Chronic hepatitis C retreatment with boceprevir in menopausal women.

Menopausal women who are infected with hepatitis C virus (HCV) represent a very difficult-to-treat cohort of patients. Menopause represents, in fact, a special time in a woman's life in which there are hormonal changes that affect the state of health. In particular, the decline of ovarian function determines an estrogen deprivation that is associated with rapid progression of hepatic fibrosis. There is, therefore, a loss of estrogen protection against inflammation, which is followed by an increase in the levels of proinflammatory cytokines: this determines a low sensitivity to antiviral therapy. In fact, a greater resistance to antiviral therapy in women with chronic hepatitis C genotype 1 was observed after the onset of menopause, with a rate of sustained virological response less than 40%. The positive results of many studies that added boceprevir to standard antiviral therapy suggests that triple therapy in a cohort of difficult-to-treat menopausal women who are HCV-positive genotype 1 with previous failure to standard therapy will result in a high percentage of complete early virological response in these patients. Therefore, there are now new opportunities for treatment of HCV-positive genotype 1 menopausal women. [ABSTRACT FROM AUTHOR]