Hepatitis C treatment response kinetics and impact of baseline predictors.
Journal article, 2011
Summary. The optimal duration of treatment for hepatitis C virus (HCV) infections is highly variable but critical for achieving cure (sustained virological response, SVR). We prospectively investigated the impact of age, fibrosis, baseline viraemia and genotype on the early viral kinetics and treatment outcome. Patients treated with peginterferon alfa-2a and ribavirin in standard dosing were included: 49 with genotype 1 treated for 48 weeks and 139 with genotype 2 or 3 treated for 24 weeks. The reduced SVR rates in patients older than 45 years, with severe liver fibrosis or pretreatment viraemia above 400 000 IU/mL were strongly associated with slower second phase declines of HCV RNA. Genotype 2/3 infections responded more rapidly than genotype 1, reaching week 4 negativity (RVR) in 59%vs 22%. We conclude that baseline response predictors such as age, fibrosis and viral load were well reflected by the early viral kinetics as assessed by repeated HCV RNA quantifications. The kinetic patterns and the high relapse rate in genotype 2/3 patients without RVR suggest that this group might benefit from treatment durations longer than 24 weeks.
pegylated interferon
ribavirin
genotype
hepatitis
HCV RNA
monitoring
Author
Magnus Lindh
University of Gothenburg
B Arnholm
Södra Älvsborgs Hospital
Anders Eilard
Uddevalla Hospital
Martti Färkkilä
Helsingin Yliopisto
Kristoffer Hellstrand
University of Gothenburg
Martin Lagging
University of Gothenburg
Nina Langeland
Helse Bergen Haukeland University Hospital
K Mørch
Helse Bergen Haukeland University Hospital
Staffan Nilsson
University of Gothenburg
Chalmers, Mathematical Sciences, Mathematical Statistics
Court Pedersen
Syddansk Universitet
Mads Rauning Buhl
Aarhus Universitet
T Wahlberg
Central Hospital Skovde
Rune Wejstål
University of Gothenburg
Johan Westin
University of Gothenburg
Gunnar Norkrans
University of Gothenburg
Journal of Viral Hepatitis
1352-0504 (ISSN) 1365-2893 (eISSN)
Vol. 18 6 400-407Subject Categories (SSIF 2011)
Microbiology in the medical area
DOI
10.1111/j.1365-2893.2010.01323.x
PubMed
20500548