Prediction of Sustained Virological Response to Combination Therapy with Pegylated Interferon Alfa and Ribavirin in Patients with Genotype 3 Chronic Hepatitis C

Tohra, Sunil; Taneja, Sunil; Ghosh, Sujata; Sharma, Bal Krishan; Duseja, Ajay; Dhiman, Radha K.; Das, Ashim; Chawla, Yogesh

doi:10.1007/s10620-011-1770-3

Cited by 30 publications

(33 citation statements)

References 39 publications

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“…The data from India had shown that the response rates to Peg-IFNa/RBV therapy in GT-3 may be lower than that reported for GT-2/3 from the west. 60,61 Patients with GT-3 should be treated either with SOF plus DCV for 12 weeks or the triple therapy of SOF plus Peg-IFNa/RBV for 12 weeks. SOF and weight-based RBV therapy should be recommended only in the unlikely event of a patient being unwilling/intolerant to DCV.…”

Section: Management Of Genotypementioning

confidence: 99%

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Puri

Saraswat

Dhiman

et al. 2016

Journal of Clinical and Experimental Hepatology

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India contributes significantly to the global burden of HCV. While the nucleoside NS5B inhibitor sofosbuvir became available in the Indian market in March 2015, the other directly acting agents (DAAs), Ledipasvir and Daclatasvir, have only recently become available in the India. The introduction of these DAA in India at a relatively affordable price has led to great optimism about prospects of cure for these patients as not only will they provide higher efficacy, but combination DAAs as all-oral regimen will result in lower side effects than were seen with pegylated interferon alfa and ribavirin therapy. Availability of these newer DAAs has necessitated revision of INASL guidelines for the treatment of HCV published in 2015. Current considerations for the treatment of HCV in India include the poorer response of genotype 3, nonavailability of many of the DAAs recommended by other guidelines and the cost of therapy. The availability of combination DAA therapy has simplified therapy of HCV with decreased reliance of evaluation for monitoring viral kinetics or drug related side effects. ( J CLIN EXP HEPATOL 2016;6:119-145) T here have been revolutionary changes in the management of chronic hepatitis C (CH-C) over the last few years. Pegylated interferon alfa (Peg-IFNa) plus ribavirin (RBV) therapy, which till the recent past was the standard of care, has been eclipsed by the arrival of newer directly acting antiviral agents (DAAs). Not only do the DAAs have better efficacy, they are also associated with lower side effects, have better tolerability, a shorter duration of therapy, and have simpler administration.In the recent guidelines issued by the American Association for the study of Liver Diseases (AASLD), in collaboration with the Infectious Diseases Society of America 1 and the European Association for Study of the Liver z (EASL), 2 the role of Peg-IFNa/RBV therapy in the management of HCV has been relegated to second-line, backup status. These newer guidelines, however, cannot be implemented in India as many of the recommended drugs are yet to be marketed in India. Other considerations for the treatment of HCV in India are a predominance of

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Section: Management Of Genotypementioning

confidence: 99%

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Puri

Saraswat

Dhiman

et al. 2016

Journal of Clinical and Experimental Hepatology

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“…Even though our end of treatment response rate (44%) is less than that in non-CKD patients, it is still acceptable and may improve with increasing number of patients. 11 Though it is always advisable to follow patients with CHC and look for an SVR 24 weeks after the end of treatment; in patients with CKD and CHC, kidney transplantation can be done one month after the end of treatment rather than waiting for another 24 weeks. 2 We had SVR data available only in one patient and six patients who were lost to follow-up presumably underwent kidney transplantation after achieving their ETR.…”

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confidence: 99%

Treatment of chronic hepatitis C in end stage renal disease: experience at a tertiary care centre

Duseja

Choudhary²,

Gupta³

et al. 2012

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“…The overall SVR rate among G-3 patients reported in our study (82.6%) is comparable to the SVR rates of 76-84% reported in most of the studies from the western world. 7,[15][16][17] However, few studies 18,19 have reported lower SVR rates (66-68%) in genotype 3 patients. Difference in the patient population and dosage of ribavirin might be responsible for this variation.…”

Section: Discussionmentioning

confidence: 99%

Optimal Duration of Pegylated Interferon Plus Ribavirin Therapy for Chronic Hepatitis C Genotype 3 Patients who do not Achieve Rapid Virological Response

Sood

Midha

2015

Journal of Clinical and Experimental Hepatology

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Background/Objectives: Chronic hepatitis C (CHC) genotype-3 (G-3) patients treated with standard 24-week pegylated interferon plus ribavirin(PEG-RBV) therapy achieve sustained virological response(SVR) rate of 69-82%. Patients who do not achieve rapid virological response(RVR) have lower SVR rate. Data regarding optimal management of this subgroup is scarce. We aimed to determine the most appropriate treatment duration in CHC G-3 patients who do not achieve RVR. Methods: Treatment na € õve CHC G-3 patients treated with PEG-RBV therapy were included in this retrospective analysis. Patients with cirrhosis were excluded. RVR was assessed in all patients beyond the year 2007. RVR non-achievers were advised extended treatment beyond 24 weeks. Results: Of the total 685 patients started on treatment, 646 completed treatment (mean age 39.1 ± 12 years, 68.3% males). In the pre-'RVR assessment ' period (2004-2006), SVR with standard 24 week therapy was 72.3% (112/155). In post-'RVR assessment ' period (2007-2013), 75.8% (402/530) patients achieved RVR; and 91.5% (368/402) of these achieved SVR with standard 24 weeks therapy. Among RVR non-achievers (n = 128), 51 patients opted for extended 36 week therapy, 12 for 48 week therapy, while 65 stopped therapy at 24 weeks. Choice of treatment duration was dependent entirely on the affordability of the patient. SVR with extended therapy (36/48 weeks) was significantly higher than standard 24 week therapy in RVR non-achievers (82.5% vs. 52.3%; P = 0.003). However, SVR rate in 36 week group was not significantly different from 48 week group (84.3% vs. 75%; P = 0.425]. On multivariate analysis, duration of treatment (36/48 week vs. 24 week; P < 0.001) was significantly associated with SVR. Conclusions: SVR rates in CHC G-3 patients treated with PEG-RBV in northern India were comparable to western data. Standard 24 week therapy is adequate for RVR-achievers. However, in RVR non-achievers, extended 36 week therapy significantly improves SVR, while further extension to 48 week does not provide any additional advantage. ( J CLIN EXP HEPATOL 2015;5:2-7)

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Prediction of Sustained Virological Response to Combination Therapy with Pegylated Interferon Alfa and Ribavirin in Patients with Genotype 3 Chronic Hepatitis C

Abstract: Combination therapy with PEG-IFN-α and RBV demonstrated good tolerability in CHC genotype 3 infection. Age, BMI, and alcohol consumption play an important role in determining treatment outcome.

Cited by 30 publications

References 39 publications

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Indian National Association for Study of the Liver (INASL) Guidance for Antiviral Therapy Against HCV Infection: Update 2016

Treatment of chronic hepatitis C in end stage renal disease: experience at a tertiary care centre

Optimal Duration of Pegylated Interferon Plus Ribavirin Therapy for Chronic Hepatitis C Genotype 3 Patients who do not Achieve Rapid Virological Response

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