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News

Early virologic response to treatment in patients with chronic hepatitis C

Patients with chronic hepatitis C who fail to achieve early virologic response will not clear the virus even if an additional 9 months of therapy is received, find researchers in the September issue of Hepatology.

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Interferon-based therapy for patients with chronic hepatitis C is increasingly effective. The virus may be eradicated in over half of cases.

The early identification of non-responding patients is desirable as it allows treatment to be stopped.

In this study, a team from the United States examined differing degrees of viral inhibition during early treatment (early virologic response [EVR]) with pegylated interferon alpha-2b and ribavirin (PEG/R). The team's aim was to identify patients who would not respond to therapy.

They considered that the best definition of EVR was a reduction in hepatitis C virus (HCV) RNA by at least 2 logs after the first 12 weeks of treatment when compared to baseline.

The team found that up to 76% of patients achieved this threshold, depending on the treatment regimen. A sustained virologic response (SVR) was achieved in 67% to 80% of these patients.

The researchers determined that patients who did not reach EVR did not respond to further therapy.
Up to 76% of patients achieved early virologic response.
Hepatology

Furthermore, they calculated that if treatment was stopped in patients without EVR, drug costs would be reduced by more than 20%.

Dr Gary Davis's team concluded, "Early confirmation of viral reduction following initiation of antiviral therapy for chronic hepatitis C is worthwhile".

"It provides a goal to motivate adherence during the first months of therapy and a milepost at which to reassess the need for continued treatment".

"Most patients who are able to complete the first 12 weeks of therapy achieve EVR and have a high probability of SVR".

"Patients who fail to achieve EVR will not clear virus even if an additional 9 months of therapy is received".

"Therapy can be confidently discontinued in those cases".

Hepatology 2003; 38: 645-52
28 August 2003

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