Durability of Sustained Virologic Response in Chronic Hepatitis C: Analysis of Factors Related to Relapse after Sustained Virologic Response with Peginterferon Plus Ribavirin Combination Therapy

Abstract

Background/Aims: Pegylated interferon plus ribavirin combination therapy has been the standard of therapy for patients with chronic hepatitis C. Although previous studies have reported long term durability after the sustained virologic response (SVR) with standard therapy for chronic hepatitis C, it is still unclear in Korea. The aim of this study was to evaluate the relapse rate and related factors after SVR to pegylated interferon therapy in Korean patients with chronic hepatitis C. Methods: A total of 119 chronic hepatitis C patients were treated with pegylated interferon plus ribavirin, and 73 patients achieved SVR (61.3%). Among 73 patients who achieved SVR, 68 patients (genotype 1, n=40; genotype non-1, n=28) were evaluated for virological response after SVR. Results: SVR rate in genotype 1 and genotype non-1 were 52.5%, and 65.1%, respectively. Relapse after SVR occurred in 5 patients (7.4%) with genotype 1, and the median time to relapse from SVR was 10 months. Univariate analysis revealed that the dose reduction of pegylated interferon (p=0.005) and cirrhosis (p=0.03) were significantly associated with relapse. Conclusions: These results suggested that the relapse could occur even after SVR achievement in Korean patients with chronic hepatitis C, and the dose reduction of pegylated interferon during treatment or having cirrhosis may increased the risk for relapse. (Korean J Gastroenterol 2011;57:173-179)

Efficacy of regimens containing pegylated interferon and ribavirin in the treatment of chronic hepatitis C: A retrospective overview

“…In some studies, on the other hand, higher sustained viral response was received from patients with high viral load (> 850,000 IU/mL) compared to those with low viral load (9,(18)(19)(20)(21) In a study performed on recurrence after treatment, HCV RNA was determined in 7 (2%) patients out of 400, 5 of them were followed-up, and HCV RNA was found again in 2 patients (0.5%) 12 months after the treatment (24). On the other hand, there are studies in which late recurrence rates were high: Lee JE et al (25), Reichard et al (26), and Khokhar et al (27) reported the rates as 7.4%, 8%, and 8.8%, respectively. These inconsistencies result from PCR methods used in varying sensitivity and patient populations.…”