| Revue: | Annals of hepatology |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000416603 |
| ISSN: | 1665-2681 |
| Autores: | Knop, Viola1 Teuber, Gerlinde2 Klinker, Hartwig3 Moller, Bernd Rasenack, Jens4 Hinrichsen, Holger Gerlach, Tilman5 Spengler, Ulrich6 Buggisch, Peter7 Neumann, Konrad8 Sarrazin, Christoph9 Zeuzem, Stefan9 Berg, Thomas1 |
| Instituciones: | 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 |
| Año: | 2013 |
| Periodo: | Mar-Abr |
| Volumen: | 12 |
| Número: | 2 |
| Paginación: | 190-198 |
| País: | México |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Aplicado, analítico |
| Resumen en inglés | 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 |
| Disciplinas: | Medicina |
| Palabras clave: | 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 |
| Texte intégral: | Texto completo (Ver PDF) |
