RNA Assessment Predicts Hepatitis C Relapse Two Weeks into Treatment
AUGUST 30, 2016
Therapy options for hepatitis C now include sofosbuvir (SOF), ribavirin (RBV), pegylated-interferon-alfa (PegIFN), simeprevir (SMV), and daclatasvir (DCV). The research team studied 298 patients with hepatitis C, genotypes 1 to 5, treated with the following medication combinations:
- 99 patients: SOF/RBV for 12 or 24 weeks
- 79 patients: SOF/DCV with or without RBV for 12 or 24 weeks
- 69 patients: SOF/SMV with or without RBV for 12 weeks
- 51 patients: PegIFN/SOF/RBV for 12 weeks
Published in the Journal of Hepatology, the results showed that hepatitis C RNA levels in people with HCV genotype 3 who achieved sustained virologic response (SVR) were significantly lower during the first four weeks of SOF/RBV treatment than the levels observed in those who ended up relapsing.
“All genotype 3 patients with a week two result of <45 IU/ml by CAP/CTM achieved SVR, but only 33% of those with >45 IU/ml” achieved SVR, the authors reported. “Similar results were documented with ART and 60 IU/ml as cut-off (SVR: 100% vs. 29%).” However, there was no significant relationship with RNA levels during early treatment and the other treatments.
ART assay was able to detect residual hepatitis C RNA at later stages of treatment, but many patients still remained at SVR. For patients on SOF/SMV with or without RBV treatment, 92% achieved SVR, and ART detected hepatitis C RNA in 20% of them.
“Hepatitis C RNA levels assessed at week two of SOF/RBV therapy can predict relapse in genotype 3 patients,” the team confirmed. More sensitive ART may be able to pick up on RNA levels at later stages of SOF-based therapies, but that doesn’t not mean treatment should be extended.
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