Long-term follow-up of patients with chronic hepatitis C with sustained virologic response to interferon

Abstract

Background and aim:The durability of the sustained virologic response (SVR) in patients with chronic hepatitis C after treatment and the ideal follow-up time for these patients remains undefi ned. The objective of the study was to evaluate the durability of the virologic response in patients with chronic hepatitis C followed up for at least 12 months after SVR at HCFMRP-USP. Methods: The study was conducted on 174 patients with chronic hepatitis C treated with different antiviral regimens who had achieved SVR. Qualitative serum HCV-RNA was determined by the commercial kit (COBAS AMPLICOR HCV, v2.0). Results: There was predominance of male (73%) with a mean age of 45.6 ± 10 years. Liver cirrhosis was present in 16.1% of the study subjects. Mean follow-up time after SVR was 47 months (12-156 months). Twenty-two patients received monotherapy with interferon; 94 received interferon plus ribavirin, and 58 received pegylated interferon plus ribavirin. A total of 134 patients (77.0%) received one treatment course, 29 (16.7%) received two courses, and 11 (6.3%) received three courses. The distribution of HCV genotypes was: genotype 1 (40.2%), genotype 3 (40.8%) and genotype 2 (10.3%). Genotype was undetermined in 8.7% of cases. None of the 174 patients had recurrence of HCV infection. Two cirrhotic patients developed hepatocellular carcinoma (HCC) during follow-up. Conclusions: Among patients with SVR there was no recurrence of HCV infection or evidence of liver disease progression in any patient followed up for a mean of 47 months after SVR, except for patients with advanced hepatic disease before treatment, who may develop HCC despite SVR. Therefore, one can assume that SVR is associated with long term good prognosis.

The follow-up results with sustained virologic response in chronic hepatitis C patients in Şanlıurfa/Turkey

“…Among these patients, long-term follow-up following SVR did not reveal any detectable GCV RNA in any of the patients. 32 Similarly, in the current study, no relapse was seen in patients who achieved SVR with two courses of treatment. No development of cirrhosis or HCC was observed during the follow-up period.…”

Cocaine Use and Liver Disease are Associated with All-Cause Mortality in the Miami Adult Studies in HIV (MASH) Cohort

“…In addition, HIV infected illicit drug users have lower access to HIV and HCV treatments [16–19] and are at greater risk for treatment failure due to lower adherence to treatment [20]. In HIV/HCV co-infected patients, therapeutic cure of HCV infection may not reduce or reverse hepatic fibrosis and its complications [21, 22]. Patients may not achieve sustained virological response (SVR), may develop occult Hepatitis C [23], which will affect immune recovery [24, 25], may decompensate due to drug and alcohol abuse [26], or develop hepatic malignancy, even after HCV is controlled [27].…”

Long-term maintenance of sustained virological response in liver transplant recipients treated for recurrent hepatitis C

“…Immunocompetent patients seem to lose SVR in 0-9% of cases, especially if they are treated with standard non-pegylated IFN alone and in the presence of advanced fibrosis or cirrhosis [19][20][21][22][23][24]. Notably, HCV reinfection due to ongoing risk-taking behaviours is still possible after SVR has been achieved [25], and surveillance for early HCC diagnosis should be maintained, at least in patients with established cirrhosis [20,21,[26][27][28][29][30].…”

“…Notably, HCV reinfection due to ongoing risk-taking behaviours is still possible after SVR has been achieved [25], and surveillance for early HCC diagnosis should be maintained, at least in patients with established cirrhosis [20,21,[26][27][28][29][30].…”