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.

monitoring

hepatitis

HCV RNA

genotype

ribavirin

pegylated interferon

Author

Magnus Lindh

University of Gothenburg

B Arnholm

Södra Älvsborg Hospital (SÄS)

Anders Eilard

Uddevalla Hospital

Martti Färkkilä

University of Helsinki

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

Chalmers, Mathematical Sciences, Mathematical Statistics

University of Gothenburg

Court Pedersen

University of Southern Denmark

Mads Rauning Buhl

Aarhus University

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 6 400-407

Subject Categories

Microbiology in the medical area

DOI

10.1111/j.1365-2893.2010.01323.x

PubMed

20500548

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9/6/2018 1