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Very Low Viral Load (VLVL) Relapse Following Treatment of Naïve Patients with Chronic Hepatitis C

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Abstract

Background

Sustained virologic response (SVR) to treatment of naïve patients with chronic hepatitis C (HCV) with pegylated interferon and ribavirin is 50–60%. Patients who relapse have a poor response to re-treatment. We report a group of relapse patients with SVR to low-dose re-treatment after 6 months.

Aim

Characterization of HCV relapse patients with very low viral load (VLVL) (HCV RNA <5,000 IU/ml) 6 months after stopping full-dose initial treatment.

Methods

We identified 120 consecutive naïve patients over 4 years treated with pegylated interferon alpha-2a and ribavirin with full-dose therapy for 24 weeks (non-genotype 1) or 48 weeks (genotype 1) with baseline liver biopsy and at least 6 months of follow-up after treatment. HCV RNA by PCR and hepatic blood tests were obtained monthly during treatment and at least 1, 3, and 6 months post treatment.

Results

Of the initially treated patients, 54.2% had SVR, 25% non-response and 20.8% relapsed. Four of 25 who relapsed (16%) and one similar patient referred to our program had HCV RNA <5,000 IU/ml 6 months after stopping treatment (VLVL relapse). Significant differences (P < 0.05) compared with the 21 other relapse patients included all five patients who were genotype 1; 4/5 had cirrhosis, baseline HCV RNA was lower, and all had SVR to less intensive re-treatment for 6 months.

Conclusion

VLVL relapse patients should be sought, because SVR to re-treatment is common despite genotype 1 cirrhosis.

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There are no financial arrangements related to the research or assistance with manuscript preparation.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, H. H. Chao Comprehensive Digestive Disease Center, UCI Medical Center, 101 The City Drive South, Building 53, Room 113, Orange, CA, 92868, USA

    John Carl Hoefs & Bernard Joseph Ilagan

  2. Mercy Hospital and Medical Center, 2525 South Michigan Ave, Chicago, IL, 60616, USA

    Vikramjit S. Aulakh

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  1. John Carl Hoefs
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  2. Vikramjit S. Aulakh
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  3. Bernard Joseph Ilagan
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Correspondence to Bernard Joseph Ilagan.

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Hoefs, J.C., Aulakh, V.S. & Ilagan, B.J. Very Low Viral Load (VLVL) Relapse Following Treatment of Naïve Patients with Chronic Hepatitis C. Dig Dis Sci 57, 243–249 (2012). https://doi.org/10.1007/s10620-011-1973-7

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