Int J Med Sci 2016; 13(4):310-315. doi:10.7150/ijms.14953
Sustained Virologic Response at 24 Weeks after the End of Treatment Is a Better Predictor for Treatment Outcome in Real-World HCV-Infected Patients Treated by HCV NS3/4A Protease Inhibitors with Peginterferon plus Ribavirin
1. Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan;
2. Department of Molecular Virology, Chiba University Graduate School of Medicine, Chiba, Japan;
3. Kikkoman General Hospital, Noda, Chiba, Japan;
4. Safety and Health Organization, Chiba University, Chiba, Japan
Kanda T, Nakamoto S, Sasaki R, Nakamura M, Yasui S, Haga Y, Ogasawara S, Tawada A, Arai M, Mikami S, Imazeki F, Yokosuka O. Sustained Virologic Response at 24 Weeks after the End of Treatment Is a Better Predictor for Treatment Outcome in Real-World HCV-Infected Patients Treated by HCV NS3/4A Protease Inhibitors with Peginterferon plus Ribavirin. Int J Med Sci 2016; 13(4):310-315. doi:10.7150/ijms.14953. Available from http://www.medsci.org/v13p0310.htm
Background. Direct-acting antiviral agents against HCV with or without peginterferon plus ribavirin result in higher eradication rates of HCV and shorter treatment duration. We examined which is better for predicting persistent virologic response, the assessment of serum HCV RNA at 12 or 24 weeks after the end of treatment for predicting sustained virologic response (SVR12 or SVR24, respectively) in patients treated by HCV NS3/4A protease inhibitors with peginterferon plus ribavirin.
Methods. In all, 149 Japanese patients infected with HCV genotype 1b treated by peginterferon plus ribavirin with telaprevir or simeprevir were retrospectively analyzed: 59 and 90 patients were treated with telaprevir- and simeprevir-including regimens, respectively. HCV RNA was measured by TaqMan HCV Test, version 2.0, real-time PCR assay. SVR12 or SVR24, respectively, was defined as HCV RNA negativity at 12 or 24 weeks after ending treatment.
Results. Total SVR rates were 78.0% and 66.7% in the telaprevir and simeprevir groups, respectively. In the telaprevir group, all 46 patients with SVR12 finally achieved SVR24. In the simeprevir group, 60 (93.8%) of the total 64 patients with SVR12 achieved SVR24, with the other 4 patients all being previous-treatment relapsers.
Conclusions. SVR12 was suitable for predicting persistent virologic response in almost all cases. In simeprevir-including regimens, SVR12 could not always predict persistent virologic response. Clinicians should use SVR24 for predicting treatment outcome in the use of HCV NS3/4A protease inhibitors with peginterferon plus ribavirin for any group of real-world patients chronically infected with HCV.
Keywords: direct-acting antivirals, HCV RNA, hepatitis C, sustained virologic response