Individualized treatment strategy according to early viral kinetics in hepatitis C virus type 1-infected patients

Berg, Thomas; Weich, V.; Teuber, G.; Klinker, Hartwig; Möller, B.; Rasenack, J.; Hinrichsen, Holger; Gerlach, Tilman; Spengler, Ulrich; Buggisch, Peter; Balk, H.; Zankel, M.; Neumann, Konrad; Sarrazin, Christoph; Zeuzem, Stefan

doi:10.1002/hep.22991

Cited by 55 publications

(89 citation statements)

References 26 publications

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“…Patients with RVR have an approximately 90% chance of treatment success after standard of care with peginterferon/ribavirin combination therapy, regardless of the viral genotypes. 2,4,26,27 The achievement of this early goal provides greater flexibility for tailoring the treatment duration on an individual basis and also enhances the costeffectiveness of treatment. 28 An awareness of what baseline factors can predict RVR before treatment is therefore pivotal.…”

Section: Discussionmentioning

confidence: 99%

Role of interleukin-28B polymorphisms in the treatment of hepatitis C virus genotype 2 infection in Asian patients

et al. 2011

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Genome-wide association studies have linked single nucleotide polymorphisms (SNPs) near the interleukin-28B gene to the hepatitis C virus genotype 1 (HCV-1) response to peginterferon/ribavirin treatment. We aimed to explore the impact on the treatment outcomes of Asian HCV-2 patients. We determined rs8105790, rs8099917, rs4803219, and rs10853728 to be candidate SNPs in 482 Asian HCV-2 patients treated with the standard of care. Because the first three SNPs were in very strong linkage disequilibrium with one another (r 2 5 0.94-0.96), rs8099917 and rs10853728 were selected for an analysis of their influence on the achievement of rapid virological response [RVR; seronegativity for hepatitis C virus (HCV) RNA in treatment week 4] and sustained virological response (SVR; seronegativity for HCV RNA throughout 24 weeks of posttreatment follow-up). The rs10853728 genotype did not predict RVR or SVR in HCV-2 patients. However, patients with the rs8099917 TT genotype, in comparison with patients with GT/GG genotypes, had a significantly higher rate of achieving RVR (85.2% versus 72.0%, P 5 0.017) but did have not a significantly higher rate of achieving SVR (89.4% versus 86.0%). Multivariate analysis revealed that a baseline HCV viral load <400,000 IU/mL was the strongest predictor of RVR [odds ratio (OR) 5 4.27, 95% confidence interval (CI) 5 2.31-7.87, P < 0.001], and this was followed by advanced liver fibrosis (OR 5 0.28, 95% CI 5 0.15-0.53, P < 0.001), the carriage of the rs8099917 TT genotype (OR 5 3.10, 95% CI 5 1.34-7.21, P 5 0.008), and the pretreatment level of aspartate aminotransferase (OR 5 0.996, 95% CI 5 0.99-1.00, P 5 0.04). Nevertheless, the achievement of RVR was the single predictor of SVR with an OR of 19.37 (95% CI 5 8.89-42.23, P < 0.001), whereas the rs8099917 genotypes played no role in achieving SVR with or without RVR. Conclusion: The rs8099917 TT genotype is significantly independently predictive of RVR, which is the single best predictor of SVR, in Asian HCV-2 patients. (HEPATOLOGY 2011;53:7-13)

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Section: Discussionmentioning

confidence: 99%

Role of interleukin-28B polymorphisms in the treatment of hepatitis C virus genotype 2 infection in Asian patients

et al. 2011

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“…[52][53][54][55][56][57][58][59] Two of the articles were abstracts 57,58 linked to full publications. 53,60 All of the included studies report peginterferon and ribavirin combination therapy in patients eligible for shortened treatment duration (i.e.…”

Section: Quantity and Quality Of Research Availablementioning

confidence: 99%

“…Ribavirin was administered orally, according to body weight, at a dose of 1000 mg/day for patients weighing ≤ 75 kg and 1200 mg/day for patients weighing > 75 kg in four studies, [52][53][54][55] or 800 mg/day for patients weighing ≤ 65 kg, 1000 mg/day for patients weighing 65-85 kg, and 1200 mg/day for patients weighing > 85 kg in one study. 56 Berg and colleagues 59 reported only that patients received 800-1400 mg/day ribavirin and it is assumed that the dose was administered according to body weight. It should be noted that in two trials, 55,56 the doses of ribavirin used are higher than those stipulated in the current licence for peginterferon alfa-2a and ribavirin combination treatment (800 mg/day for genotype 2/3 42,62 ) owing to changes in the licence since these studies were carried out.…”

Section: Description Of the Included Trialsmentioning

confidence: 99%

“…Four trials evaluated treatment in patients with genotype 1, [52][53][54]59 with two of these 53,54 comparing the standard 48 weeks' treatment duration with a shorter 24 weeks' treatment duration. The other two genotype 1 studies 52,59 randomised patients to the standard 48 weeks' treatment duration or to a variable treatment duration based on the time when HCV RNA first became undetectable.…”

Section: Description Of the Included Trialsmentioning

confidence: 99%

“…The other two genotype 1 studies 52,59 randomised patients to the standard 48 weeks' treatment duration or to a variable treatment duration based on the time when HCV RNA first became undetectable. In the Mangia and colleagues trial, 52 patients who were first HCV RNA negative at weeks 4, 8 and 12 were treated for 24, 48 and 72 weeks, respectively; in the Berg and colleagues trial, 59 time to first HCV RNA negativity was multiplied by a factor of 6, such that patients who were first HCV RNA negative at weeks 3, 4, 5, 6, 7 or 8 were treated for 18, 24, 30, 36, 42 or 48 weeks, respectively. One trial by Yu and colleagues 55 assessed treatment in patients with genotype 2, comparing the standard 24 weeks' treatment duration with a shorter 16 weeks' treatment duration.…”

Section: Description Of the Included Trialsmentioning

confidence: 99%

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Peginterferon alfa and ribavirin for chronic hepatitis C in patients eligible for shortened treatment, re-treatment or in HCV/HIV co-infection: a systematic review and economic evaluation

Hartwell

Jones²,

Baxter³

et al. 2011

Health Technol Assess

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Computerized advice on drug dosage to improve prescribing practice

Gillaizeau

Chan

Trinquart

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Cochrane Database of Systematic Reviews

121

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Individualized treatment strategy according to early viral kinetics in hepatitis C virus type 1-infected patients

Cited by 55 publications

References 26 publications

Role of interleukin-28B polymorphisms in the treatment of hepatitis C virus genotype 2 infection in Asian patients

Role of interleukin-28B polymorphisms in the treatment of hepatitis C virus genotype 2 infection in Asian patients

Peginterferon alfa and ribavirin for chronic hepatitis C in patients eligible for shortened treatment, re-treatment or in HCV/HIV co-infection: a systematic review and economic evaluation

Computerized advice on drug dosage to improve prescribing practice

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