Revisiting the predictors of a sustained virologic response in the era of direct-acting antiviral therapy for hepatitis C virus
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Revisiting the predictors of a sustained virologic response in the era of direct-acting antiviral therapy for hepatitis C virus. / Beinhardt, Sandra; Rutter, Karoline; Stättermayer, Albert Friedrich; Ferenci, Peter.
In: CLIN INFECT DIS, Vol. 56, No. 1, 01.01.2013, p. 118-22.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Revisiting the predictors of a sustained virologic response in the era of direct-acting antiviral therapy for hepatitis C virus
AU - Beinhardt, Sandra
AU - Rutter, Karoline
AU - Stättermayer, Albert Friedrich
AU - Ferenci, Peter
PY - 2013/1/1
Y1 - 2013/1/1
N2 - Several host (age, sex, race, fibrosis stage, interleukin 28B polymorphism) and viral factors (hepatitis C virus [HCV] genotype, viral load) allow estimating the response to interferon-based therapies (which includes first-generation protease inhibitors) before treatment. However, treatment should not be denied to any patient based on unfavorable factors alone. Metabolic conditions associated with poor response (diabetes, insulin resistance, obesity) and alcohol abuse can be influenced before starting treatment. "On-treatment" predictors of response allow treatment to be tailored to the individual need of the patient. Patients with undetectable HCV RNA after 4 weeks (rapid virologic response [RVR]) have the highest chance for cure (>85%) both by dual and triple therapy. For triple therapy, the decision to shorten treatment requires that the virus remains undetectable for an additional 8 (telaprevir) to 20 (boceprevir) weeks (extended RVR). Based on viral kinetics, an even earlier prediction after 2 weeks of treatment with direct acting antivirals appears feasible.
AB - Several host (age, sex, race, fibrosis stage, interleukin 28B polymorphism) and viral factors (hepatitis C virus [HCV] genotype, viral load) allow estimating the response to interferon-based therapies (which includes first-generation protease inhibitors) before treatment. However, treatment should not be denied to any patient based on unfavorable factors alone. Metabolic conditions associated with poor response (diabetes, insulin resistance, obesity) and alcohol abuse can be influenced before starting treatment. "On-treatment" predictors of response allow treatment to be tailored to the individual need of the patient. Patients with undetectable HCV RNA after 4 weeks (rapid virologic response [RVR]) have the highest chance for cure (>85%) both by dual and triple therapy. For triple therapy, the decision to shorten treatment requires that the virus remains undetectable for an additional 8 (telaprevir) to 20 (boceprevir) weeks (extended RVR). Based on viral kinetics, an even earlier prediction after 2 weeks of treatment with direct acting antivirals appears feasible.
KW - Adult
KW - Antiviral Agents
KW - Female
KW - Hepacivirus
KW - Hepatitis C
KW - Host-Pathogen Interactions
KW - Humans
KW - Interferon-alpha
KW - Interleukins
KW - Male
KW - Polyethylene Glycols
KW - RNA, Viral
KW - Recombinant Proteins
KW - Ribavirin
KW - Sensitivity and Specificity
KW - Treatment Outcome
KW - Viral Load
U2 - 10.1093/cid/cis843
DO - 10.1093/cid/cis843
M3 - SCORING: Journal article
C2 - 23024292
VL - 56
SP - 118
EP - 122
JO - CLIN INFECT DIS
JF - CLIN INFECT DIS
SN - 1058-4838
IS - 1
ER -