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News

Determinants of relapse after short course of antiviral therapy in Hep C

A study in this week’s Hepatology examines determinants of relapse after a short course of antiviral therapy in patients with chronic Hep C virus genotype 2 or 3 infection.

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In Hepatitis C virus genotypes 2 and 3 patients, the high rate of relapse after 12 to 16 weeks of antiviral therapy is the main concern for shortening treatment duration.

Dr Alessandra Mangia and colleagues from Italy delineated predictors of relapse after short treatment in patients with undetectable Hepatitis C virus RNA at treatment at week 4.

In addition, the research team evaluated the sustained virological response after a second 24-week course of therapy.

Relapse patients received pegylated interferon (Peg-IFN) alfa-2b (1.5 g/kg) and ribavirin (1000-1200 mg/day) for 12 weeks.

Those who relapsed were re-treated with the same drug doses but for the extended standard duration of 24 weeks.

83% attained sustained virological response
Hepatology

Logistic regression analysis was applied to delineate predictors of relapse by using age, sex, route of transmission, body mass index.

Serum alanine aminotransferase, Hepatitis C virus genotypes, serum Hepatitis C virus RNA levels, and platelet counts as covariates.

The researchers found that of 718 patients with genotypes 2 and 3 who were started on therapy, 69% had undetectable Hepatitis C virus RNA at week 4.

Of them, 83% attained sustained virological response, and 14% relapsed.

At regression analysis, only platelet count less than 140,000 mm3, and body mass index 30 or higher were independently associated with relapse.

The team reported that 43 of 67 patients with relapse agreed to be re-treated, and an sustained virological response was achieved in 70% of them.

Dr Mangia’s team concluded, “We recommend 12 weeks course of therapy for patients with undetectable Hepatitis C virus RNA at treatment week 4, providing they present with no advanced fibrosis and low body mass index.”

 

 

 

 

Hepatol 2009: 49(2): 358-63


04 February 2009

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