F F Poordad1. 1. Hepatology and Liver Transplantation, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA. Fred.Poordad@cshs.org
Abstract
BACKGROUND: For patients with chronic hepatitis C, attaining rapid virological response (RVR) is highly predictive of attaining SVR. AIM: To consider the predictive value of RVR in terms of SVR and relapse. METHODS: Data were collected from published clinical trials to define the predictive value of RVR for SVR and evaluate the proposed continuum linking RVR to relapse. RESULTS: These data support a 24-week regimen among genotype (G)1 patients who attain RVR with positive predictive values (PPVs) of 77.8% and 85.7% in patients with G1 infection treated for 24 and 48 weeks. Conversely, failure to attain RVR among G1 patients should not be viewed as a criterion for extending treatment duration beyond 48 weeks: negative predictive values (NPVs) were 60.9% and 52.7% in G1 patients without RVR treated for 48 and 72 weeks. Among G2/3 patients, RVR has a high PPV; however, the NPV varied with treatment duration indicating that a 24-week treatment regimen is warranted in G2/3 patients who fail to attain RVR. CONCLUSIONS: The present analysis confirms RVR as a strong predictor of SVR that can be used to tailor treatment duration, but which also should be appreciated in the context of treatment duration and regimen.
BACKGROUND: For patients with chronic hepatitis C, attaining rapid virological response (RVR) is highly predictive of attaining SVR. AIM: To consider the predictive value of RVR in terms of SVR and relapse. METHODS: Data were collected from published clinical trials to define the predictive value of RVR for SVR and evaluate the proposed continuum linking RVR to relapse. RESULTS: These data support a 24-week regimen among genotype (G)1 patients who attain RVR with positive predictive values (PPVs) of 77.8% and 85.7% in patients with G1 infection treated for 24 and 48 weeks. Conversely, failure to attain RVR among G1 patients should not be viewed as a criterion for extending treatment duration beyond 48 weeks: negative predictive values (NPVs) were 60.9% and 52.7% in G1 patients without RVR treated for 48 and 72 weeks. Among G2/3 patients, RVR has a high PPV; however, the NPV varied with treatment duration indicating that a 24-week treatment regimen is warranted in G2/3 patients who fail to attain RVR. CONCLUSIONS: The present analysis confirms RVR as a strong predictor of SVR that can be used to tailor treatment duration, but which also should be appreciated in the context of treatment duration and regimen.
Authors: Benjamin P Linas; Devra M Barter; Jared A Leff; Madeline DiLorenzo; Bruce R Schackman; Charles R Horsburgh; Sabrina A Assoumou; Joshua A Salomon; Milton C Weinstein; Arthur Y Kim; Kenneth A Freedberg Journal: AIDS Date: 2014-01-28 Impact factor: 4.632
Authors: Douglas Dieterich; Tarik Asselah; Dominique Guyader; Thomas Berg; Marcus Schuchmann; Stefan Mauss; Vlad Ratziu; Peter Ferenci; Dominique Larrey; Andreas Maieron; Jerry O Stern; Melek Ozan; Yakov Datsenko; Wulf Otto Böcher; Gerhard Steinmann Journal: Antimicrob Agents Chemother Date: 2014-04-07 Impact factor: 5.191