Hepatitis C genotype 1 virus with low viral load and rapid virologic response to peginterferon/ribavirin obviates a protease inhibitor

Pearlman, Brian L.; Ehleben, Carole

doi:10.1002/hep.26624

Cited by 40 publications

(37 citation statements)

References 35 publications

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“…Pharmacoeconomic analyses and clinical studies suggest that the "cost per SVR" still favours the use of pegIFN-RBV dual-therapy, rather than PI-based triple-therapy, in patients complying "easyto-treat criteria", such as those who exhibit excellent viral response during the first 4 weeks of treatment with pegIFN and RBV alone [30,[32][33][34][35]. On the other hand, for patients who do not fully comply with predictors of viral-response (i.e.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis C virus RNA levels at week-2 of telaprevir/boceprevir administration are predictive of virological outcome

Cento

Paolo

Carlo

et al. 2015

Digestive and Liver Disease

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a b s t r a c tBackground: Triple therapy with telaprevir/boceprevir + pegylated-interferon + ribavirin can achieve excellent antiviral efficacy, but it can be burdened with resistance development at failure. Aims: To evaluate kinetics of hepatitis C virus (HCV) RNA decay and early resistance development, in order to promptly identify patients at highest risk of failure to first generation protease inhibitors. Methods: HCV-RNA was prospectively quantified in 158 patients receiving pegylatedinterferon + ribavirin + telaprevir (N = 114) or + boceprevir (N = 44), at early time-points and during per protocol follow-up. Drug resistance was contextually evaluated by population sequencing. Results: HCV-RNA at week-2 was significantly higher in patients experiencing virological failure to triple-therapy than in patients with sustained viral response (2.3 [1.9-2.8] versus 1.2 [0.3-1.7] log IU/mL, p < 0.001). A 100 IU/mL cut-off value for week-2 HCV-RNA had the highest sensitivity (86%) in predicting virological success. Indeed, 23/23 (100%) patients with undetectable HCV-RNA reached success, versus 26/34 (76.5%) patients with HCV-RNA < 100 IU/mL, and only 11/31 (35.5%) with HCV-RNA > 100 IU/mL (p < 0.001). Furthermore, differently from failing patients, none of the patient with undetectable HCV-RNA at week-2 had baseline/early resistance. Cento et al. / Digestive and Liver Disease xxx (2014) xxx-xxx Conclusions: With triple therapy based on first generation protease inhibitors, suboptimal HCV-RNA decay at week-2 combined with early detection of resistance can help identifying patients with higher risk of virological failure, thus requiring a closer monitoring during therapy.

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Section: Discussionmentioning

confidence: 99%

Hepatitis C virus RNA levels at week-2 of telaprevir/boceprevir administration are predictive of virological outcome

Cento

Paolo

Carlo

et al. 2015

Digestive and Liver Disease

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“…First, even though guidelines will gravitate towards these newer preferred treatments, the universal use of present or future triple therapies is certainly an overtreatment for the subset of patients with favourable clinical, genetic, and virological profiles [12,13,30]. Several scientific societies issued position papers stating that treatment-naïve patients with favourable baseline and on-treatment predictive features do not necessarily deserve triple therapy [11,12], a recommendation which has undergone a formal validation in a recent clinical trial [13]. Secondly, facing the cost of upcoming interferon-free therapies will be an issue.…”

Section: Discussionmentioning

confidence: 99%

“…Several guidelines recommend for all previously untreated HCV-1 patients to commence therapy with a 4-week phase of PEG/RBV before the addition of a protease inhibitor [9][10][11][12]. Albeit this strategy would allow patients with rapid virological response (RVR) to obviate the use of a protease inhibitor [13] and could eventually be utilized to adjust treatment duration [5,14], it would expose naïve patients unlikely to obtain RVR to suboptimal therapy.…”

Section: Introductionmentioning

confidence: 99%

An a priori prediction model of response to peginterferon plus ribavirin dual therapy in naïve patients with genotype 1 chronic hepatitis C

Andriulli

Nardi

Marco

et al. 2014

Digestive and Liver Disease

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Peg-interferon and ribavirin treatment Predictors of sustained virological response, Rapid virological response a b s t r a c t Background: Aim was to select naïve patients with genotype 1 chronic hepatitis C having a high probability of response to Peg-interferon + ribavirin therapy. Methods: In 1073 patients (derivation cohort), predictors of rapid and sustained virological response were identified by logistic analysis; regression coefficients were used to generate prediction models for sustained virological response. Probabilities at baseline and treatment week 4 were utilized to develop a decision rule to select patients with high likelihood of response. The model was then validated in 423 patients (validation cohort). Results: In the derivation cohort, 257 achieved rapid virological response and 818 did not, with sustained virological response rates of 80.2% and 25.4%, respectively; interleukin-28B polymorphisms, fibrosis staging, gamma-glutamyl transferase, and viral load predicted sustained virological response. Assuming a <30% sustained virological response probability for not recommending Peg-interferon + ribavirin, 100 patients (25.6%) in the validation cohort were predicted a priori to fail this regimen. Assuming a ≥80% sustained virological response probability as a threshold to continue with Peg-interferon + ribavirin, 61 patients were predicted to obtain sustained virological response, and 55 of them (90.2%) eventually did. Conclusions: This model uses easily determined variables for a personalized estimate of the probability of sustained virological response with Peg-interferon + ribavirin, allowing to identify patients who may benefit from conventional therapy.

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“…Yapılabiliyorsa subtip tayini proteaz inhibitörleriyle tedavi yanıtını öngörmekte yararlı olabilir (50,89).…”

Section: Karaciğer Hastalığının şIddeti Ve Bazal Virolojik Göstergelerunclassified

Management of Chronic Hepatitis C Virus Infection: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases

Aygen¹,

Keten²,

Akalın³

et al. 2015

Klimik Dergisi

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ÖzetTürk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği Viral Hepatit Çalışma Grubu, dünyada yaklaşık olarak 170 milyon kişide bulunan kronik hepatit C virusu (HCV) infeksiyonunun yönetimine ilişkin bir uzlaşı raporu hazırlamak üzere bir toplantı düzenlemiştir. Raporda konuyla ilgili literatür ve uluslararası kılavuzlar, HCV infeksiyonunun epidemiyolojisi ve doğal seyri, kronik hepatit C (KHC)'nin ülke ekonomisine maliyeti, akut hepatit C (AHC) ve KHC tanısı, AHC tedavisi, KHC'de tedavinin amaçları, tedavi yanıtlarının tanımları, tedavinin sonlandırılma AbstractStudy Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases convened a meeting to develop a consensus report on management of chronic hepatitis C virus (HCV) infection, a global public health problem, affecting nearly 170 million people worldwide. Relevant literature and international guidelines were reviewed, and recommendations agreed are presented at the end of each section such as epidemiology and natural history of HCV infection, economic burden of chronic hepatitis C (CHC), diagnosis of acute hepatitis

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Hepatitis C genotype 1 virus with low viral load and rapid virologic response to peginterferon/ribavirin obviates a protease inhibitor

Cited by 40 publications

References 35 publications

Hepatitis C virus RNA levels at week-2 of telaprevir/boceprevir administration are predictive of virological outcome

Hepatitis C virus RNA levels at week-2 of telaprevir/boceprevir administration are predictive of virological outcome

An a priori prediction model of response to peginterferon plus ribavirin dual therapy in naïve patients with genotype 1 chronic hepatitis C

Management of Chronic Hepatitis C Virus Infection: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases

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