Prediction of minimal residual viremia in HCV type 1 infected patients receiving interferon-based therapy



Document title: Prediction of minimal residual viremia in HCV type 1 infected patients receiving interferon-based therapy
Journal: Annals of hepatology
Database: PERIÓDICA
System number: 000416603
ISSN: 1665-2681
Authors: 1
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Institutions: 1Universitatsmedizin, Berlín. Alemania
2Interdisziplinäres Facharztzentrum, Frankfurt, Hessen. Alemania
3Universitat Wurzburg, Wurzburg, Baviera. Alemania
4Medizinische Universitat Freiburg, Freiburg. Alemania
5Klinik Augustinum Munchen, Munich, Baviera. Alemania
6Medizinische Universitatsklinik, Bonn, Nordrhein-Westfalen. Alemania
7Institut fur Interdisziplinäre Medizin, Hamburgo. Alemania
8Institut fur Biometrie und klinische Epidemiologie, Berlín. Alemania
9Goethe University, Medizinische Klinik 1, Frankfurt, Hessen. Alemania
Year:
Season: Mar-Abr
Volumen: 12
Number: 2
Pages: 190-198
Country: México
Language: Inglés
Document type: Artículo
Approach: Aplicado, analítico
English abstract Complete suppression of viral replication is crucial in chronic HCV treatment in order to prevent relapse and resistance development. We wanted to find out which factors influence the period from being already HCV RNA negative by bDNA assay (< 615 IU/mL) to become undetectable by the more sensitive TMA test (< 5.3 IU/mL). Material and methods. Evaluated were 433 HCV type 1-infected patients. All of them received 1.5 ug/kg Peg-IFNα-2b plus ribavirin for 18-48 weeks. bDNA was performed weekly during the first 8 weeks and thereafter at weeks 12, 24, and 48. Patients who became bDNA undetectable were additionally analysed by TMA. Results. Of the 309 patients with on-treatment response (< 615 IU/mL), 289 also reached undetectable HCV RNA levels by TMA. Multivariate analysis revealed that viremia ≤ 400,000 IU/mL (p = 0.001), fast initial virologic decline (p = 0.004) and absence of fibrosis (p = 0.035) were independent predictors of an accelerated on-treatment response by TMA assay in already bDNA negative patients. bDNA negative patients becoming HCV RNA undetectable by TMA within the following 3 weeks had a frequency of relapse of 21%, whereas those showing TMA negativity after 3 weeks relapsed in 38% (p = 0.001). In RVR patients (bDNA < 615 IU/mL at week 4) the corresponding relapse rates were 15.3% vs. 37.5%, respectively (p = 0.003). Conclusion. Early viral kinetics, baseline viremia and fibrosis stage are important tools to predict persistent minimal viremia during interferon-based therapy. The data have implications for designing a more refined treatment strategy in HCV infection, even in the setting of protease inhibitor-based triple treatment
Disciplines: Medicina
Keyword: Gastroenterología,
Terapéutica y rehabilitación,
Virus,
Hepatitis C,
Hepatitis crónica,
Viremia,
Interferón,
Respuesta al tratamiento,
Replicación viral
Keyword: Gastroenterology,
Therapeutics and rehabilitation,
Virus,
Hepatitis C,
Chronic hepatitis,
Viremia,
Interferon,
Treatment response,
Viral replication
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