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Rapid virological response tailors the duration of treatment in hepatitis C virus genotype 3 patients treated with pegylated interferon alfa-2a and ribavirin in Pakistan.
Int J Infect Dis. 2013 Nov; 17(11):e1017-21.IJ

Abstract

BACKGROUND

Rapid virological response (RVR) is now thought to be the strongest predictor of sustained virological response (SVR) in hepatitis C virus (HCV) patients undergoing antiviral therapy. It can be used as a guide to individualize treatment duration. The aim of this study was to assess the role of RVR in tailoring the duration of treatment.

METHODS

Patients with HCV genotype 3 infections were enrolled and treated with pegylated interferon alfa-2a (PEG IFN alfa-2a) 180 μg/week and ribavirin. HCV RNA was analyzed at weeks 4, 12, 16, and 24. Treatment duration was individualized on the basis of RVR. Patients who achieved RVR and who were aged ≤ 40 years with a body mass index (BMI) ≤ 27 kg/m(2) received 16 weeks of treatment (group A). Patients who achieved RVR and were aged >40 years with a BMI >27 kg/m(2), aged >40 years with a BMI ≤ 27 kg/m(2), and aged ≤ 40 years with a BMI >27 kg/m(2) received 24 weeks of treatment (group B). Patients who did not achieve RVR but who achieved an early virological response (EVR; HCV PCR-negative or ≥ 2 log drop in HCV RNA at week 12) were treated with 24 weeks of therapy (group C).

RESULTS

SVR was observed in 86% in group A, 82.2% in group B, and 46.8% in group C. A difference was observed in SVR for patients with and without RVR and receiving the standard duration of treatment (82.2% vs. 46.8%, p<0 .001). The results show that the rate of SVR is not inferior in those with RVR treated with 16 weeks of therapy compared to 24 weeks (86% vs. 82.2%, p=0.004).

CONCLUSIONS

RVR is useful to individualize the duration of treatment and to predict the treatment outcome. A short treatment of 16 weeks is as effective as 24 weeks in HCV genotype 3 patients who achieve RVR, who have a low BMI, and are younger in age.

Authors+Show Affiliations

Maroof International Hospital, Islamabad, Pakistan. Electronic address: gill95res@gmail.com.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23896656

Citation

Gill, Uzma, et al. "Rapid Virological Response Tailors the Duration of Treatment in Hepatitis C Virus Genotype 3 Patients Treated With Pegylated Interferon Alfa-2a and Ribavirin in Pakistan." International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, vol. 17, no. 11, 2013, pp. e1017-21.
Gill U, Aziz H, Gill ML. Rapid virological response tailors the duration of treatment in hepatitis C virus genotype 3 patients treated with pegylated interferon alfa-2a and ribavirin in Pakistan. Int J Infect Dis. 2013;17(11):e1017-21.
Gill, U., Aziz, H., & Gill, M. L. (2013). Rapid virological response tailors the duration of treatment in hepatitis C virus genotype 3 patients treated with pegylated interferon alfa-2a and ribavirin in Pakistan. International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases, 17(11), e1017-21. https://doi.org/10.1016/j.ijid.2013.05.012
Gill U, Aziz H, Gill ML. Rapid Virological Response Tailors the Duration of Treatment in Hepatitis C Virus Genotype 3 Patients Treated With Pegylated Interferon Alfa-2a and Ribavirin in Pakistan. Int J Infect Dis. 2013;17(11):e1017-21. PubMed PMID: 23896656.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rapid virological response tailors the duration of treatment in hepatitis C virus genotype 3 patients treated with pegylated interferon alfa-2a and ribavirin in Pakistan. AU - Gill,Uzma, AU - Aziz,Hafsa, AU - Gill,Muzaffar Lateef, Y1 - 2013/07/27/ PY - 2012/06/22/received PY - 2013/05/09/revised PY - 2013/05/22/accepted PY - 2013/7/31/entrez PY - 2013/7/31/pubmed PY - 2014/5/9/medline KW - HCV genotype 3 KW - PEG IFN KW - RVR SP - e1017 EP - 21 JF - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases JO - Int. J. Infect. Dis. VL - 17 IS - 11 N2 - BACKGROUND: Rapid virological response (RVR) is now thought to be the strongest predictor of sustained virological response (SVR) in hepatitis C virus (HCV) patients undergoing antiviral therapy. It can be used as a guide to individualize treatment duration. The aim of this study was to assess the role of RVR in tailoring the duration of treatment. METHODS: Patients with HCV genotype 3 infections were enrolled and treated with pegylated interferon alfa-2a (PEG IFN alfa-2a) 180 μg/week and ribavirin. HCV RNA was analyzed at weeks 4, 12, 16, and 24. Treatment duration was individualized on the basis of RVR. Patients who achieved RVR and who were aged ≤ 40 years with a body mass index (BMI) ≤ 27 kg/m(2) received 16 weeks of treatment (group A). Patients who achieved RVR and were aged >40 years with a BMI >27 kg/m(2), aged >40 years with a BMI ≤ 27 kg/m(2), and aged ≤ 40 years with a BMI >27 kg/m(2) received 24 weeks of treatment (group B). Patients who did not achieve RVR but who achieved an early virological response (EVR; HCV PCR-negative or ≥ 2 log drop in HCV RNA at week 12) were treated with 24 weeks of therapy (group C). RESULTS: SVR was observed in 86% in group A, 82.2% in group B, and 46.8% in group C. A difference was observed in SVR for patients with and without RVR and receiving the standard duration of treatment (82.2% vs. 46.8%, p<0 .001). The results show that the rate of SVR is not inferior in those with RVR treated with 16 weeks of therapy compared to 24 weeks (86% vs. 82.2%, p=0.004). CONCLUSIONS: RVR is useful to individualize the duration of treatment and to predict the treatment outcome. A short treatment of 16 weeks is as effective as 24 weeks in HCV genotype 3 patients who achieve RVR, who have a low BMI, and are younger in age. SN - 1878-3511 UR - https://www.unboundmedicine.com/medline/citation/23896656/Rapid_virological_response_tailors_the_duration_of_treatment_in_hepatitis_C_virus_genotype_3_patients_treated_with_pegylated_interferon_alfa_2a_and_ribavirin_in_Pakistan_ L2 - http://linkinghub.elsevier.com/retrieve/pii/S1201-9712(13)00208-7 DB - PRIME DP - Unbound Medicine ER -