Late relapse in chronic hepatitis c after sustained viral response to interferon and ribavirin

Khokhar, Nasir

doi:10.1111/j.1440-1746.2004.03289.x

Cited by 12 publications

(6 citation statements)

References 5 publications

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“…It should be pointed out that these studies involved different periods of follow-up, varying defi nitions of biochemical and virologic response, as well as PCR tests with different sensitivity thresholds for the detection of HCV-RNA. 10,13,15,20,24 Such variability was of limited utility to guide clinicians about the ideal length of follow-up of treated patients with chronic hepatitis C who achieved SVR after antiviral treatment.…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up of patients with chronic hepatitis C with sustained virologic response to interferon

Ferreira¹,

Carneiro²,

Souza³

et al. 2010

Braz J Infect Dis

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Background and aim:The durability of the sustained virologic response (SVR) in patients with chronic hepatitis C after treatment and the ideal follow-up time for these patients remains undefi ned. The objective of the study was to evaluate the durability of the virologic response in patients with chronic hepatitis C followed up for at least 12 months after SVR at HCFMRP-USP. Methods: The study was conducted on 174 patients with chronic hepatitis C treated with different antiviral regimens who had achieved SVR. Qualitative serum HCV-RNA was determined by the commercial kit (COBAS AMPLICOR HCV, v2.0). Results: There was predominance of male (73%) with a mean age of 45.6 ± 10 years. Liver cirrhosis was present in 16.1% of the study subjects. Mean follow-up time after SVR was 47 months (12-156 months). Twenty-two patients received monotherapy with interferon; 94 received interferon plus ribavirin, and 58 received pegylated interferon plus ribavirin. A total of 134 patients (77.0%) received one treatment course, 29 (16.7%) received two courses, and 11 (6.3%) received three courses. The distribution of HCV genotypes was: genotype 1 (40.2%), genotype 3 (40.8%) and genotype 2 (10.3%). Genotype was undetermined in 8.7% of cases. None of the 174 patients had recurrence of HCV infection. Two cirrhotic patients developed hepatocellular carcinoma (HCC) during follow-up. Conclusions: Among patients with SVR there was no recurrence of HCV infection or evidence of liver disease progression in any patient followed up for a mean of 47 months after SVR, except for patients with advanced hepatic disease before treatment, who may develop HCC despite SVR. Therefore, one can assume that SVR is associated with long term good prognosis.

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Section: Discussionmentioning

confidence: 99%

Long-term follow-up of patients with chronic hepatitis C with sustained virologic response to interferon

Ferreira¹,

Carneiro²,

Souza³

et al. 2010

Braz J Infect Dis

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“…Despite well‐described early virological, end of treatment and SVR rates in HCV‐treated patients, late relapse rates after achieving an SVR have been less well defined. Delayed relapse rates of 0–9% have been reported in the few available studies, all of which involve variable follow‐up periods, inconsistent biochemical and virological response definitions and differing PCR assays [8–11]. There is thus limited information available to guide the clinician in the follow‐up of patients who have achieved an SVR.…”

Section: Discussionmentioning

confidence: 99%

“…Late virological relapse (detectable HCV RNA post documented SVR) rates of 0% in five patients followed for a mean of 10 years, 0% in 14 patients followed for 1.5 years and 4% in 75 patients followed for 3.4 years have been reported in patients treated with interferon monotherapy [8–10]. A late relapse rate of 8.7% during a 2.6‐year follow‐up period has been described in 57 patients treated with interferon plus ribavirin [11]. These studies have involved HCV PCR assays with varying degrees of sensitivity and a range of patient populations.…”

Section: Introductionmentioning

confidence: 99%

Sustained virological response rates and durability of the response to interferon‐based therapies in hepatitis C patients treated in the clinical setting

Desmond

Roberts

Dudley

et al. 2005

Journal of Viral Hepatitis

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International controlled trials have demonstrated increasing sustained virological response (SVR) rates to interferon-based therapies in hepatitis-C-treated patients. Response rates of 6-20% in the era of interferon monotherapy are compared with 42-82% with pegylated interferon plus ribavirin. The virological durability of the SVR is unknown and the optimal follow-up for these patients is unclear. The aim of our study was to determine SVR rates and the durability of the response to interferon-based therapies in the clinical setting. From our database of 1540 hepatitis C patients, 344 treatment courses of at least 12 weeks duration were identified, including interferon monotherapy (175 patients), interferon plus ribavirin (96 patients) and peginterferon plus ribavirin (73 patients). Interferon monotherapy was associated with an SVR rate of 5% in 103 genotype 1 patients and 25% in 72 genotype 2/3 patients. Response rates were higher (P < 0.001) with interferon plus ribavirin-41% in 34 genotype 1 patients and 73% in 62 genotype 2/3 patients-and with peginterferon plus ribavirin-47% in 47 genotype 1 patients and 79% in 26 genotype 2/3 patients. Of 147 patients with an SVR, 146 (>99%) remained hepatitis C virus PCR negative during a mean 2.3 years (range 0.3-10.3) of follow-up. In conclusion, with advances in therapies, we are achieving higher response rates in hepatitis C patients treated in the clinical setting. We can now expect an SVR in over half of the treated patients. Importantly, the response is durable and medium and long-term follow-up of these patients are of low yield and largely unnecessary.

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“…This situation is almost synonymous with healing of HCV infection, because a subsequent reappearance is described as a sporadic and unexpected event [1], with favorable repercussions on long-term prognosis [2,3].…”

Section: Introductionmentioning

confidence: 99%

From Trials to a Real Hospital Setting: Effectiveness of Pegylated Interferon-α-2b/Ribavirin Combination Therapy for Naïve Chronic Hepatitis C Patients

Piai¹,

Scalice²,

Focareta³

et al. 2006

Dig Dis Sci

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Registration trials regarding pegylated interferon treatment of hepatitis C have created great expectations for improved results, but there is little information on actual outcomes in everyday hospital practice. We aimed to define the effectiveness of this treatment in a hospital setting. Seventy-four naïve patients with hepatitis C treated with 12 kD-pegylated-interferon-alpha-2-b/ribavirin (PEG-IFN) were retrospectively analyzed in comparison with 54 patients treated with IFN-alpha-2-b/ribavirin (STANDARD IFN) and with results of three main registration trials. Overall sustained viral response rates were 46% in the STANDARD IFN group and 54% in PEG-IFN group, ranging from 48-61% in similar arms of the registration trials considered, although more of our patients presented comorbidity and high-grade fibrosis, and our dosages at outset of PEG-IFN were lower than optimal (mean 1.18 microg/kg BW). In our hospital setting, the effectiveness of PEG-IFN/ribavirin therapy appeared similar to that reported in large registration trials.

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Late relapse in chronic hepatitis c after sustained viral response to interferon and ribavirin

Cited by 12 publications

References 5 publications

Long-term follow-up of patients with chronic hepatitis C with sustained virologic response to interferon

Long-term follow-up of patients with chronic hepatitis C with sustained virologic response to interferon

Sustained virological response rates and durability of the response to interferon‐based therapies in hepatitis C patients treated in the clinical setting

From Trials to a Real Hospital Setting: Effectiveness of Pegylated Interferon-α-2b/Ribavirin Combination Therapy for Naïve Chronic Hepatitis C Patients

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