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1.
Figure 7

Figure 7. Viral load in response to pegIFNα2b, ribavirin, SAMe and betaine in 3 patients with an EVR in their previous treatment.. From: S-Adenosyl-Methionine and Betaine Improve Early Virological Response in Chronic Hepatitis C Patients with Previous Nonresponse.

3 patients had achieved an EVR in their previous treatment, but no EoTR. They all achieved EVR when re-treated with the study medication. None of them had an SVR.

Magdalena Filipowicz, et al. PLoS One. 2010;5(11):e15492.
2.
Figure 5

Figure 5. Viral load in 4 patients with a complete early virological response to pegIFNα2b, ribavirin, SAMe and betaine.. From: S-Adenosyl-Methionine and Betaine Improve Early Virological Response in Chronic Hepatitis C Patients with Previous Nonresponse.

4 patients with a cEVR to the study treatment (color code  =  green), all of them previous nonresponders. Patient #25 had an SVR.

Magdalena Filipowicz, et al. PLoS One. 2010;5(11):e15492.
3.
Figure 9

Figure 9. Distribution of early virological response to previous treatments and to the study medication.. From: S-Adenosyl-Methionine and Betaine Improve Early Virological Response in Chronic Hepatitis C Patients with Previous Nonresponse.

86% of the 29 study patients had a primary non-response (PNR) to their previous combination treatments with (peg)IFNα/ribarivin. The rate of PNR was reduced to 41% by addition of SAMe and betaine to pegIFNα/ribavirin. Three patients achieved an SVR with the study medication.

Magdalena Filipowicz, et al. PLoS One. 2010;5(11):e15492.
4.
Figure 8

Figure 8. Biochemical response to study medication.. From: S-Adenosyl-Methionine and Betaine Improve Early Virological Response in Chronic Hepatitis C Patients with Previous Nonresponse.

Shown are box plot diagrams of the ALAT values at baseline (BL), week 4 (w4), w12, w24, w48 and follow up (FU) in 12 patients without response to the study medication (left panel) and 17 patients with an EVR (right panel). The blue line shows the upper limit of normal.

Magdalena Filipowicz, et al. PLoS One. 2010;5(11):e15492.
5.
Figure 6

Figure 6. Viral load in 8 patients with an early virological response to pegIFNα2b, ribavirin, SAMe and betaine.. From: S-Adenosyl-Methionine and Betaine Improve Early Virological Response in Chronic Hepatitis C Patients with Previous Nonresponse.

8 patients had >2 log reduction of VL after 12 weeks of combination treatment but had still detectable HCV RNA (EVR, color code  =  yellow). All of them had been previous nonresponders. No patient in this group had an SVR.

Magdalena Filipowicz, et al. PLoS One. 2010;5(11):e15492.
6.
Figure 3

Figure 3. Viral load in 12 patients with nonresponse to pegIFNα2b, ribavirin, SAMe and betaine.. From: S-Adenosyl-Methionine and Betaine Improve Early Virological Response in Chronic Hepatitis C Patients with Previous Nonresponse.

12 patients had no virological response to the study medication (Primary non-response, PNR, color code  =  grey). The left panel shows VL during the first 12 weeks of the previous treatment. The right panel shows VL during the study therapy. Indicated on the left from top to bottom are treatment group (A or B), sex (m or f), age at the start of the therapy, GT and Metavir fibrosis stage. The previous treatment (either pegIFNα/ribavirin oder IFNα/ribavirin) is indicated on top of the left panel.

Magdalena Filipowicz, et al. PLoS One. 2010;5(11):e15492.
7.
Figure 4

Figure 4. Viral load in 2 patients with rapid virological response to pegIFNα2b, ribavirin, SAMe and betaine.. From: S-Adenosyl-Methionine and Betaine Improve Early Virological Response in Chronic Hepatitis C Patients with Previous Nonresponse.

2 patients showed an RVR to the study treatment (color code  =  blue), both had no virological response in the previous treatment. Both patients had an SVR. The left panel shows VL during the first 12 weeks of the previous treatment. The right panel shows VL during the study therapy. Indicated on the left from top to bottom are treatment group (A or B), sex (m or f), age at the start of the therapy, GT and Metavir fibrosis stage. The previous treatment (either pegIFNα/ribavirin oder IFNα/ribavirin) is indicated on top of the left panel.

Magdalena Filipowicz, et al. PLoS One. 2010;5(11):e15492.
8.
Figure 2

Figure 2. Effect of pretreatment with SAMe and betaine on HCV viral load.. From: S-Adenosyl-Methionine and Betaine Improve Early Virological Response in Chronic Hepatitis C Patients with Previous Nonresponse.

A) HCV viral load (VL) at baseline (BL) was slightly higher in group A than group B (6.51 versus 6.0 log10 IU/ml, t-test p = 0.017). Shown is a box plot diagram. B) In group A, no significant effect of SAMe and betaine pretreatment on HCV VL was observed after one week. C) Reduction in HCV VL compared to the BL value (in log10 IU/ml) during the first 12 weeks of treatment in group A (dark grey bars) and group B (light grey bars). VL reduction was significantly different at day 1 and 2, but not at later time points (unpaired t-test, p = 0.03 at d1, p = 0.04 at d2).

Magdalena Filipowicz, et al. PLoS One. 2010;5(11):e15492.
9.
Figure 1

Figure 1. Design of the study.. From: S-Adenosyl-Methionine and Betaine Improve Early Virological Response in Chronic Hepatitis C Patients with Previous Nonresponse.

Patients were randomized into two groups. Patients in group A received a pre-treatment for one week with SAMe (1200 mg/day) and betaine (6 g/day), and were then treated for 3 (nonresponders) to 6 (genotypes 2 and 3) or 12 (genotypes 1 and 4) months with a combination of SAMe, betaine, ribavirin twice daily p.o. at a weight adjusted total daily dose of 800–1200 mg, and pegIFNα2b (1.5 µg/kg) injected s.c. once per week. Patients in group B received pegIFNα2b and ribavirin during the first week, followed by a combination of pegIFNα2b, ribavirin, SAMe and betaine at the same doses as outlined above for group A. The figure depicts treatment duration at the example of a patient infected with HCV genotype 1.

Magdalena Filipowicz, et al. PLoS One. 2010;5(11):e15492.

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