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Viral-guided hepatitis C therapy

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Abstract

Predicting hepatitis C treatment outcomes is of great benefit to patient and clinician. Baseline predictors of response or failure can set the appropriate expectations for the patient and may aid in decision making about starting therapy. An accurate assessment of the potential for treatment success involves using rapid and early viral kinetics at weeks 4 and 12. These time points are useful to set up stopping rules and to provide motivation for the patient and health care provider to continue when appropriate. Relapse is an unfortunate consequence of therapy in a significant number of patients. Baseline and on-treatment viral assessments are useful in helping predict and perhaps reduce this phenomenon.

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References and Recommended Reading

  1. Manns MP, McHutchison JG, Gordon SC, et al.: Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Lancet 2001, 358:958–965.

    Article  PubMed  CAS  Google Scholar 

  2. Fried MW, Shiffman ML, Reddy KR, et al.: Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 2002, 347:975–982.

    Article  PubMed  CAS  Google Scholar 

  3. Roche B, Sebagh M, Canfora ML, et al.: Hepatitis C virus therapy in liver transplant recipients: response predictors, effect on fibrosis progression, and importance of the initial stage of fibrosis. Liver Transpl 2008, 14:1766–1777.

    Article  PubMed  Google Scholar 

  4. Torriani FJ, Rodriguez-Torres M, Rockstroh JK, et al.: Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection in HIV-infected patients. N Engl J Med 2004, 351:438–450.

    Article  PubMed  CAS  Google Scholar 

  5. Sulkowski M, Lawitz E, Shiffman ML, et al.: Final results of the IDEAL (individualized dosing efficacy versus flat dosing to assess optimal pegylated interferon therapy) phase IIIb study. Presented at the 43rd Annual Meeting of the European Association for the Study of the Liver. Milan, Italy; April 26, 2008.

  6. Strader DB, Wright T, Thomas DL, Seeff LB: Diagnosis, management, and treatment of hepatitis C. Hepatology 2004, 39:1147–1171.

    Article  PubMed  Google Scholar 

  7. Sulkowski M, Vierling JM, Brown K, et al.: Probability of sustained virologic response (SVR) is associated with the magnitude of HCV RNA reduction at week 4 of treatment with peginterferon (Peg) plus ribavirin (RBV): results of the IDEAL trial. Hepatology 2008, 48(Suppl 4):A1868.

    Google Scholar 

  8. Zeuzem S, Buti M, Ferenci P, et al.: Efficacy of 24 weeks treatment with peginterferon alfa-2b plus ribavirin in patients with chronic hepatitis C infected with genotype 1 and low pretreatment viremia. J Hepatol 2006, 44:97–103.

    Article  PubMed  CAS  Google Scholar 

  9. Jensen DM, Morgan TR, Marcellin P, et al.: Early identification of HCV genotype 1 patients responding to 24 weeks peginterferon alpha-2a (40 kd)/ribavirin therapy. Hepatology 2006, 43:954–960.

    Article  PubMed  CAS  Google Scholar 

  10. Hadziyannis SJ, Sette H Jr, Morgan TR, et al.: Peginterferon-a2a and ribavirin combination therapy in chronic hepatitis C: a randomized study of treatment duration and ribavirin dose. Ann Intern Med 2004, 140:346–355.

    PubMed  CAS  Google Scholar 

  11. Davis GL, Wong JB, McHutchison JG, et al.: Early virologic response to treatment with peginterferon alfa-2b plus ribavirin in paotients with chronic hepatitis C. Hepatology 2003, 38:645–652.

    Article  PubMed  CAS  Google Scholar 

  12. Marcellin P, Jensen DM, Hadziyannis SJ, Ferenci P: Differentiation of early virologic response (EVR) into RVR, complete EVR (CEVR) and partial EVR (PEVR) allows for a more precise prediction of SVR in HCV genotype 1 patients treated with peginterferon alfa-2a (40kd) (Pegasys) and ribavirin (Copegus). Hepatology 2007, 46:818A.

    Google Scholar 

  13. Ferenci P, Fried MW, Shiffman ML, et al.: Predicting sustained virological responses in chronic hepatitis C patients treated with peginterferon alfa-2a (40 KD)/ribavirin. J Hepatol 2005, 43:425–433.

    Article  PubMed  CAS  Google Scholar 

  14. Mangia A, Minerva N, Bacca D, et al.: Individualized treatment duration for hepatitis C genotype 1 patients: a randomized controlled trial. Hepatology 2008, 47:43–50.

    Article  PubMed  CAS  Google Scholar 

  15. Berg T, von Wagner M, Nasser S, et al.: Extended treatment duration for hepatitis C virus type 1: comparing 48 versus 72 weeks of peginterferon-alfa-2a plus ribavirin. Gastroenterology 2006, 130:1086–1097.

    Article  PubMed  CAS  Google Scholar 

  16. Pearlman BL, Ehleben C, Saifee S: Treatment extension to 72 weeks of peginterferon and ribavirin in hepatitis c genotype 1-infected slow responders. Hepatology 2007, 46:1688–1694.

    Article  PubMed  CAS  Google Scholar 

  17. Crespo M, Sauleda S, Esteban JI, et al.: Peginterferon alpha-2b plus ribavirin vs interferon alpha-2b plus ribavirin for chronic hepatitis C in HIV-coinfected patients. J Viral Hepat 2007, 14:228–238.

    Article  PubMed  CAS  Google Scholar 

  18. Payan C, Pivert A, Morand P, et al.: AnRS HC02 RIBAVIC study team: Rapid and early virological response to chronic hepatitis C treatment with IFN alpha2b or PEG-IFN alpha2b plus ribavirin in HIV/HCV co-infected patients. Gut 2007, 56:1111–1116.

    Article  PubMed  CAS  Google Scholar 

  19. Drusano GL, Preston SL: A 48-week duration of therapy with pegylated interferon afa 2b plus ribavirin may be too short to maximize long-term response among patients infected with genotype-1 hepatitis C virus. J Infect Dis 2004, 189:964–970.

    Article  PubMed  CAS  Google Scholar 

  20. Marcellin P, Heathcote EJ, Craxi A: Which patients with genotype 1 chronic hepatitis C can benefit from prolonged treatment with the “accordion” regimen? J Hepatol 2007, 47:580–587.

    Article  PubMed  CAS  Google Scholar 

  21. Poynard T, Colombo M, Bruix J, et al.: Sustained viral response is dependent on baseline characteristics in the re-treatment of previous interferon/ribavirin nonresponders: final results from the EPIC 3 program. J Hepatol 2008, 48:S369.

    Article  Google Scholar 

  22. Andriulli A, Mangia A, Iacobellis A, et al.: Meta-analysis: the outcome of anti-viral therapy in HCV genotype 2 and genotype 3 infected patients with chronic hepatitis. Aliment Pharmacol Ther 2008, 28:397–404.

    Article  PubMed  CAS  Google Scholar 

  23. Rubbia-Brandt L, Quadri R, Abid K, et al.: Hepatocyte steatosis is a cytopathic effect of hepatitis C virus genotype 3. J Hepatol 2000, 33:106–115.

    Article  PubMed  CAS  Google Scholar 

  24. Rodríguez-Torres M, Govindarajan S, Diago M, et al.: Hepatic steatosis in patients with chronic hepatitis C virus genotype 2 or 3 does not affect viral response in patients treated with peginterferon alpha-2a (40KD) (PEGASYS) plus ribavirin (COPEGUS) for 16 or 24 weeks. Liver Int 2009, 29:237–241.

    Article  PubMed  CAS  Google Scholar 

  25. Rodríguez-Torres M, Ríos-Bedoya CF, Ortiz-Lasanta G, et al.: Weight affect relapse rates in latinos with genotype 2/3 chronic hepatitis C (CHC) treated with peg IFN alfa-2a (Pegasys) 180 mcg/week and 800 mg daily of ribavirin for 24 weeks. J Med Virol 2008, 80:1576–1580.

    Article  PubMed  CAS  Google Scholar 

  26. Shiffman ML, Mihas AA, Millwala F, et al.: Treatment of chronic hepatitis C virus in African Americans with genotypes 2 and 3. Am J Gastroenterol 2007, 102:761–766.

    Article  PubMed  CAS  Google Scholar 

  27. Powis J, Peltekian KM, Lee SS, et al.: Exploring differences in response to treatment with peginterferon alpha 2a (40kD) and ribavirin in chronic hepatitis C between genotypes 2 and 3. J Viral Hepat 2008, 15:52–57.

    PubMed  CAS  Google Scholar 

  28. Weiland O, Hollander A, Mattsson L, et al.: Lower-than-standard dose PEG-IFN alfa-2a for chronic hepatitis C caused by genotype 2 and 3 is sufficient when given in combination with weight-based ribavirin. J Viral Hepat 2008, 15:641–645.

    Article  PubMed  CAS  Google Scholar 

  29. Ferenci P, Brunner H, Laferl H, et al.: A randomized, prospective trial of ribavirin 400 mg/day versus 800 mg/day in combination with peginterferon alfa-2a in hepatitis C virus genotypes 2 and 3. Hepatology 2008, 47:1816–1823.

    Article  PubMed  CAS  Google Scholar 

  30. Shiffman ML, Suter F, Bacon BR, et al.: Peginterferon alfa-2a and ribavirin for 16 or 24 weeks in HCV genotype 2 or 3. N Engl J Med 2007, 357:124–134.

    Article  PubMed  CAS  Google Scholar 

  31. Andriulli A, Mangia A, Iacobellis A, et al.: Meta-analysis: the outcome of anti-viral therapy in HCV genotype 2 and genotype 3 infected patients with chronic hepatitis. Aliment Pharmacol Ther 2008, 28:397–404.

    Article  PubMed  CAS  Google Scholar 

  32. Carlsson T, Quist A, Weiland O: Rapid viral response and treatment outcome in genotype 2 and 3 chronic hepatitis C: comparison between two HCV RNA quantitation methods. J Med Virol 2008, 80:803–807.

    Article  PubMed  CAS  Google Scholar 

  33. Dalgard O, Bjøro K, Hellum KB, et al.: Treatment with pegylated interferon and ribavarin in HCV infection with genotype 2 or 3 for 14 weeks: a pilot study. Hepatology 2004, 40:1260–1265.

    Article  PubMed  CAS  Google Scholar 

  34. Dalgard O, Bjøro K, Ring-Larsen H, et al.: Pegylated interferon alfa and ribavirin for 14 versus 24 weeks in patients with hepatitis C virus genotype 2 or 3 and rapid virological response. Hepatology 2008, 47:35–42.

    Article  PubMed  CAS  Google Scholar 

  35. Mangia A, Santoro R, Minerva N, et al.: Peginterferon alfa-2b and ribavirin for 12 vs. 24 weeks in HCV genotype 2 or 3. N Engl J Med 2005, 352:2609–2617.

    Article  PubMed  CAS  Google Scholar 

  36. von Wagner M, Huber M, Berg T, et al.: Peginterferon-alpha-2a (40KD) and ribavirin for 16 or 24 weeks in patients with genotype 2 or 3 chronic hepatitis C. Gastroenterology 2005, 129:522–527.

    Google Scholar 

  37. Yu ML, Dai CY, Huang JF, et al.: A randomized study of peginterferon and ribavirin for 16 versus 24 weeks in patients with genotype 2 chronic hepatitis C. Gut 2007, 56:553–559.

    Article  PubMed  CAS  Google Scholar 

  38. Lagging M, Langeland N, Pedersen C, et al.: Randomized comparison of 12 or 24 weeks of peginterferon alpha-2a and ribavirin in chronic hepatitis C virus genotype 2/3 infection. Hepatology 2008, 47:1837–1845.

    Article  PubMed  CAS  Google Scholar 

  39. Herrine SK, Brown RS Jr, Bernstein DE, et al.: Peginterferon alpha-2a combination therapies in chronic hepatitis C patients who relapsed after or had a viral breakthrough on therapy with standard interferon alpha-2b plus ribavirin: a pilot study of efficacy and safety. Dig Dis Sci 2005, 50:719–726.

    Article  PubMed  CAS  Google Scholar 

  40. Basso M, Torre F, Grasso A, et al.: Pegylated interferon and ribavirin in re-treatment of responder-relapser HCV patients. Dig Liver Dis 2007, 39:47–51.

    Article  PubMed  CAS  Google Scholar 

  41. Berg C, Goncales FL, Bernstein DE, et al.: Re-treatment of chronic hepatitis C patients after relapse: efficacy of peginterferon-alpha-2a (40 kDa) and ribavirin. J Viral Hepat 2006, 13:435–440.

    Article  PubMed  CAS  Google Scholar 

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  1. 8635 West Third Street, Number 1060, Los Angeles, CA, 90048, USA

    Fred Poordad

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  1. Fred Poordad
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  2. Nancy Reau
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Correspondence to Fred Poordad.

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Poordad, F., Reau, N. Viral-guided hepatitis C therapy. Curr hepatitis rep 8, 66–72 (2009). https://doi.org/10.1007/s11901-009-0010-1

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