TY - JOUR
T1 - Negative HCV-RNA 2 weeks after initiation of treatment predicts sustained virological response to pegylated interferon alfa-2a and ribavirin in patients with chronic hepatitis C
AU - Christensen, Peer Brehm
AU - Krarup, Henrik Bygum
AU - Laursen, Alex Lund
AU - Madsen, Poul Henning
AU - Pedersen, Court
AU - Schlichting, Poul
AU - Orholm, Marianne
AU - Larsen, Helmer Ring
AU - Bukh, Jens
AU - Krogsgaard, Kim
N1 - Undertegnede er Helmer Ring-Larsen ikke Helmer Ring Larsen
PY - 2012/9
Y1 - 2012/9
N2 - Objective. The aim of this study was to examine the early viral kinetics as predictor for sustained virological response (SVR) during hepatitis C treatment. Materials and methods. We included patients with biopsy-proven chronic hepatitis C and ALT above the upper limit of normal, who received a standard treatment of pegylated interferon alfa-2a and ribavirin. The HCVRNA concentration (limit of detection 20 IU/mL) was determined at days 0, 1, 2, 3, 4, 7, 14, 21 and monthly thereafter. Results. Among 46 patients who completed the trial, 30 (65%) had SVR. Low baseline viral load, IL28B genotype CC and absence of cirrhosis were statistically associated with SVR. In multivariate analysis only absence of cirrhosis and HCVRNA negativity at day 14 were independent predictors for SVR. Eight patients who became HCVRNA negative on day 14 as well as 13 of 14 patients (93%) with HCVRNA levels of <1000 IU/mL at day 7 obtained a SVR. Among 8 of 18 (44%) genotype 1 and 4 patients with more than a one log drop in HCVRNA titer at day 7, 75% achieved SVR. Conclusions. We observed a correlation between low HCVRNA titers in week 2 and SVR during pegylated interferon/ribavirin-based treatment. This may help identify a group of patients for whom SVR may be obtained without the addition of directly acting antivirals, and thereby save the patients for unnecessary side effects and the health care system for additional costs.
AB - Objective. The aim of this study was to examine the early viral kinetics as predictor for sustained virological response (SVR) during hepatitis C treatment. Materials and methods. We included patients with biopsy-proven chronic hepatitis C and ALT above the upper limit of normal, who received a standard treatment of pegylated interferon alfa-2a and ribavirin. The HCVRNA concentration (limit of detection 20 IU/mL) was determined at days 0, 1, 2, 3, 4, 7, 14, 21 and monthly thereafter. Results. Among 46 patients who completed the trial, 30 (65%) had SVR. Low baseline viral load, IL28B genotype CC and absence of cirrhosis were statistically associated with SVR. In multivariate analysis only absence of cirrhosis and HCVRNA negativity at day 14 were independent predictors for SVR. Eight patients who became HCVRNA negative on day 14 as well as 13 of 14 patients (93%) with HCVRNA levels of <1000 IU/mL at day 7 obtained a SVR. Among 8 of 18 (44%) genotype 1 and 4 patients with more than a one log drop in HCVRNA titer at day 7, 75% achieved SVR. Conclusions. We observed a correlation between low HCVRNA titers in week 2 and SVR during pegylated interferon/ribavirin-based treatment. This may help identify a group of patients for whom SVR may be obtained without the addition of directly acting antivirals, and thereby save the patients for unnecessary side effects and the health care system for additional costs.
U2 - 10.3109/00365521.2012.694905
DO - 10.3109/00365521.2012.694905
M3 - Journal article
C2 - 22670704
SN - 0036-5521
VL - 47
SP - 1115
EP - 1119
JO - Scandinavian Journal of Gastroenterology
JF - Scandinavian Journal of Gastroenterology
IS - 8-9
ER -
