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Hepatitis C treatment response kinetics and impact of baseline predictors.

Journal article
Authors Magnus Lindh
B Arnholm
Anders Eilard
M Färkkilä
Kristoffer Hellstrand
Martin Lagging
N Langeland
K Mørch
Staffan Nilsson
C Pedersen
M R Buhl
T Wahlberg
Rune Wejstål
Johan Westin
Gunnar Norkrans
Published in Journal of viral hepatitis
Volume 18
Issue 6
Pages 400-407
ISSN 1365-2893
Publication year 2011
Published at Department of Mathematical Sciences, Mathematical Statistics
Institute of Biomedicine, Department of Infectious Medicine
Pages 400-407
Language en
Links dx.doi.org/10.1111/j.1365-2893.2010...
Keywords genotype; HCV RNA; hepatitis; monitoring; pegylated interferon; ribavirin
Subject categories Microbiology in the medical area

Abstract

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.

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