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Dynamic tailoring of treatment durations improves efficiency of hepatitis C treatment with pegylated interferon and ribavirin

In English

Författare

  • M. Lindh
  • B. Arnholm
  • Per Björkman
  • K. Hellstrand
  • M. Lagging
  • S. Nilsson
  • T. Wahlberg
  • E. Wallmark
  • O. Weiland
  • R. Wejstal
  • J. Westin
  • Anders Widell
  • G. Norkrans
Visa allt

Summary, in English

The treatment durations for hepatitis C are guided by the analysis of hepatitis C virus (HCV) RNA in blood at certain time points. This multicentre, randomized open label trial evaluated the utility and performance of individualized treatment durations guided by viral decline rates in 103 patients with HCV genotype 1 infection. Pegylated interferon 2a and ribavirin were given as standard of care (SOC) for 24, 48 or 72weeks or as dynamic treatment (DT) for 2472weeks. The DT duration was based on the time point when log HCV RNA would reach 0 log copies/mL, as estimated by the second-phase decline. The rate of sustained virologic response was 63% for SOC and 54% for DT, but this difference was not significant in multiple regression analysis taking predictive factors such as interleukin-28B genotypes, age and baseline viremia into account (P=0.45). The mean required treatment time per cured patient was 51weeks for DT as compared with 58weeks for SOC (P=0.22) when given per protocol (n=95) and was significantly shorter (42 vs 51weeks) among patients who achieved undetectable HCV RNA (P=0.01). We conclude that DT was feasible and increased efficiency. The estimated time point for 0 log viral copies/mL is a new and quantitative response variable, which may be used as a complement to the qualitative variable rapid virologic response. The outcome parameter treatment weeks per cured patient could become a useful tool for comparing treatment efficiency also in the era of directly acting antivirals.

Avdelning/ar

Publiceringsår

2013

Språk

Engelska

Sidor

82-89

Publikation/Tidskrift/Serie

Journal of Viral Hepatitis

Volym

20

Issue

4

Dokumenttyp

Artikel i tidskrift

Förlag

Wiley-Blackwell

Ämne

  • Gastroenterology and Hepatology

Nyckelord

  • HCV
  • interferon
  • kinetics
  • ribavirin
  • therapy

Status

Published

Forskningsgrupp

  • Infectious Diseases Research Unit
  • Clinical Microbiology, Malmö

ISBN/ISSN/Övrigt

  • ISSN: 1365-2893