Very Low Viral Load (VLVL) Relapse Following Treatment of Naïve Patients with Chronic Hepatitis C

Hoefs, John C.; Aulakh, Vikramjit S.; Ilagan, Bernard Joseph

doi:10.1007/s10620-011-1973-7

Cited by 4 publications

(5 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The study of Hoefs et al also observes the same. 23 An immunomodulatory response against HCV may be due to the interferon induction and may therefore sustainably lower viral load (as observed in the present study). Higher "ALT levels" can sometimes suggest relapse before the reappearance of HCV RNA, but this parameter is not sufficiently reliable.…”

Section: Discussionsupporting

confidence: 59%

Hepatitis C;

Nouman¹,

Zaidi²,

Mohiuddin³

et al. 2018

TPMJ

View full text Add to dashboard Cite

ABSTRACT… Background: Hepatitis C virus (HCV) is the most communal source of non-A, non-B viral hepatitis in the world. The disease is illusory, and the majority of patients do not acquire jaundice at its onset. Treatment of hepatitis C with interferon attained a sustained virological response (SVR) in almost 50% of the patients with HCV infection. Viral genotype is important to determine the response. The present study aims to provide the incidence of relapse of HCV in patients taking interferon therapy and to identify the predictors for relapse. Study Design: Retrospective observational study. Setting: Department of Medicine, DHQ Teaching Hospital, Sargodha. Period: Two years. Methods: A total of 60 patients were retrospectively evaluated for this study. The exclusion criteria include the patients co-infected with hepatitis B virus or HIV. All the patients were monitored 2, 4, 8, 12, 16, and 24 weeks after the end of treatment with interferon alpha. Results: We observed that the patients with relapse were significantly older and heavier (P value < 0.05). At the start of treatment, viral load was higher in relapsed patients (P value < 0.04). Conclusion: On the bases of our study findings, we can conclude that low incidence of relapse occurred with interferon therapy. High ALT level, viral loads, older age and obesity were some of strong predictors of relapse among HCV patients.

show abstract

Section: Discussionsupporting

confidence: 59%

Hepatitis C;

Nouman¹,

Zaidi²,

Mohiuddin³

et al. 2018

TPMJ

View full text Add to dashboard Cite

show abstract

“…In 10 (21.3%) relapsed patients, viral load remained within one log of the baseline value. Hoefs et al () also observed a very low viral load relapse in a proportion of naive patients, all of whom achieved sustained virologic response upon retreatment. In the present study, the viral load at relapse was below 2 log of the baseline value.…”

Section: Discussionmentioning

confidence: 90%

Kinetics of relapse after pegylated interferon and ribavirin therapy for chronic hepatitis C

Brochot¹,

Riachi

Plantier³

et al. 2013

Journal of Medical Virology

View full text Add to dashboard Cite

To optimize standard treatment of chronic hepatitis C in responder patients who have achieved undetectable viral load, a prospective study was conducted to determine the factors and kinetics of virologic relapse. Responder patients were monitored 2, 4, 8, 12, 16, and 24 weeks after the end of treatment with pegylated interferon and ribavirin. Forty-seven of the 154 patients (30.5%) relapsed. Relapse was significantly associated with absence of rapid virologic response (RVR), retreatment, higher baseline viral load, older age, and lower weight-based dose of pegylated interferon. Relapse was more frequent in patients failing to achieve a RVR after receiving pegylated interferon alpha 2a < 2.5 µg/week or alpha 2b < 1.5 µg/week (P = 0.002). Among patients infected with hepatitis C virus (HCV) genotype 1 with non-CC IL-28B polymorphism (rs12979860), viral decay during treatment was lower in relapsers (P = 0.003 at week 4). Relapse was detected at weeks 2, 4, 8, and 12 after the end of treatment for 5, 8, 10, and 6 patients infected with HCV genotype 1, respectively. Positive predictive values for sustained virologic response were 70.9%, 80.2%, 91.9%, and 98.8% at weeks 2, 4, 8, and 12, respectively. Only one patient relapsed beyond 24 weeks. Closer follow-up and treatment adaptation in patients failing to achieve RVR may decrease the relapse rate in slower responders and heavier patients. Monitoring viral load as early as 1 month after the end of treatment could be useful to assess virologic response.

show abstract

“…Despite these differences in study design, the frequency of VLVL was often similar. For example, in two studies including persons with a relapse after HCV treatment, a VLVL ≤1,000 IU/ml occurred in 4% [29], and a VLVL <5,000 IU/ml in 16% of persons [15]. In evaluations of blood samples of mostly treatment-experienced persons, a VLVL <600 IU/ml occurred in 2% [1], and a VLVL <1,000 in 3.5% of persons [29].…”

Section: Discussionmentioning

confidence: 99%

“…Viral loads <600 IU/ml [1] and <5,000 IU/ml [15] have been referred to as "very low viral loads" (VLVL).…”

Section: Introductionmentioning

confidence: 99%

“…A metaanalysis on viral loads in untreated persons had exclusion criteria such as viral loads <2,000 IU/ml and genotypes other than one; the results are therefore not relevant in our context [31]. Other studies were limited to settings where the majority of persons were treatment-experienced [1, 15,29]; results are therefore not applicable to screening, where persons are treatment-naïve. More data are needed to better estimate the probability of missing HCV-positive persons with a VLVL at the time of screening, and to obtain information on their disease course.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Very Low Hepatitis C Viral Loads in Treatment-naive Persons: Do They Compromise Hepatitis C Virus Antigen Testing?

Bertisch

Brezzi

Negro

et al. 2019

Clinical Infectious Diseases

View full text Add to dashboard Cite

Background Hepatitis C virus (HCV) antigen testing is less expensive than quantitative reverse-transcription polymerase chain reaction but has lower sensitivity for very low viral load (VLVL; HCV RNA ≤3000 IU/mL). Currently the benefits of antigen testing for screening are discussed, but data on prevalence and outcomes of persons with VLVL are scarce. Methods We assessed prevalence and predictors of VLVL by logistic regression in treatment-naive participants in the Swiss Hepatitis C Cohort Study. We analyzed if the last viral load after VLVL was low, compared cirrhosis and mortality in persons with and without VLVL, and evaluated the number of samples with VLVL that were reactive by antigen testing. Results We included 2533 treatment-naive persons with available quantitative HCV RNA testing results. Overall, 133 persons (5.3%) had a VLVL. Age 18–40 years, female sex, and human immunodeficiency virus coinfection were associated with VLVL. Of 72 persons with a viral load available after VLVL, 14% had a VLVL and 17% had spontaneous viral clearance. The prevalence and incidence of cirrhosis and mortality were comparable in persons with and without VLVL; all 24 persons with VLVL and cirrhosis had excessive alcohol consumption or immunosuppression. Overall, 33% of samples with VLVL were reactive by antigen testing. Conclusions The frequency of VLVL was low. Among the persons who would probably be missed by antigen screening, some had a favorable disease course, but some had immunosuppression and liver cirrhosis. The benefit of HCV antigen testing for screening may be limited by the risk of missing patients with severe liver disease.

show abstract

Very Low Viral Load (VLVL) Relapse Following Treatment of Naïve Patients with Chronic Hepatitis C

Abstract: VLVL relapse patients should be sought, because SVR to re-treatment is common despite genotype 1 cirrhosis.

Cited by 4 publications

References 45 publications

Hepatitis C;

Hepatitis C;

Kinetics of relapse after pegylated interferon and ribavirin therapy for chronic hepatitis C

Very Low Hepatitis C Viral Loads in Treatment-naive Persons: Do They Compromise Hepatitis C Virus Antigen Testing?

Contact Info

Product

Resources

About