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Revisiting the Predictors of a Sustained Virologic Response in the Era of Direct-Acting Antiviral Therapy for Hepatitis C Virus
Several host (age, sex, race, fibrosis stage, interleukin 28B polymorphism) and viral factors (hepatitis C virus [HCV] genotype, viral load) allow estimating the response to interferon-based therapies (which includes first-generation protease inhibitors) before treatment. However, treatment should n...
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| Published in: | Clinical infectious diseases 2013-01, Vol.56 (1), p.118-122 |
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| Main Authors: | , , , |
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| Language: | English |
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| container_end_page | 122 |
| container_issue | 1 |
| container_start_page | 118 |
| container_title | Clinical infectious diseases |
| container_volume | 56 |
| creator | Beinhardt, Sandra Rutter, Karoline Stättermayer, Albert Friedrich Ferenci, Peter |
| description | Several host (age, sex, race, fibrosis stage, interleukin 28B polymorphism) and viral factors (hepatitis C virus [HCV] genotype, viral load) allow estimating the response to interferon-based therapies (which includes first-generation protease inhibitors) before treatment. However, treatment should not be denied to any patient based on unfavorable factors alone. Metabolic conditions associated with poor response (diabetes, insulin resistance, obesity) and alcohol abuse can be influenced before starting treatment. "On-treatment" predictors of response allow treatment to be tailored to the individual need of the patient. Patients with undetectable HCV RNA after 4 weeks (rapid virologic response [RVR]) have the highest chance for cure (>85%) both by dual and triple therapy. For triple therapy, the decision to shorten treatment requires that the virus remains undetectable for an additional 8 (telaprevir) to 20 (boceprevir) weeks (extended RVR). Based on viral kinetics, an even earlier prediction after 2 weeks of treatment with direct acting antivirals appears feasible. |
| doi_str_mv | 10.1093/cid/cis843 |
| format | article |
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However, treatment should not be denied to any patient based on unfavorable factors alone. Metabolic conditions associated with poor response (diabetes, insulin resistance, obesity) and alcohol abuse can be influenced before starting treatment. "On-treatment" predictors of response allow treatment to be tailored to the individual need of the patient. Patients with undetectable HCV RNA after 4 weeks (rapid virologic response [RVR]) have the highest chance for cure (>85%) both by dual and triple therapy. For triple therapy, the decision to shorten treatment requires that the virus remains undetectable for an additional 8 (telaprevir) to 20 (boceprevir) weeks (extended RVR). 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Antiparasitic agents ; Antiviral agents ; Antiviral Agents - therapeutic use ; Antiviral drugs ; Antivirals ; Biological and medical sciences ; Chronic hepatitis ; Drug therapy ; Female ; Gastroenterology ; Genotype & phenotype ; Genotypes ; Hepacivirus ; Hepacivirus - drug effects ; Hepacivirus - isolation & purification ; Hepatitis ; Hepatitis C ; Hepatitis C - blood ; Hepatitis C - drug therapy ; Hepatitis C - genetics ; Hepatitis C - virology ; Hepatitis C virus ; Host-Pathogen Interactions ; Human viral diseases ; Humans ; Infections ; Infectious diseases ; Insulin resistance ; Interferon-alpha - therapeutic use ; Interferons ; Interleukins - genetics ; Male ; Medical sciences ; Pharmacology. Drug treatments ; Polyethylene Glycols - therapeutic use ; Polymorphism ; Recombinant Proteins - therapeutic use ; Ribavirin - therapeutic use ; RNA, Viral - blood ; Sensitivity and Specificity ; Treatment Outcome ; Viral diseases ; VIRAL HEPATITIS ; Viral Load ; Virology ; Viruses</subject><ispartof>Clinical infectious diseases, 2013-01, Vol.56 (1), p.118-122</ispartof><rights>Copyright © 2013 Oxford University Press on behalf of the Infectious Diseases Society of America</rights><rights>Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2012. 2012</rights><rights>2014 INIST-CNRS</rights><rights>Copyright Oxford University Press, UK Jan 1, 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c532t-439ef64afb47e9249a6de1b02074e423b2edb81d4dbdd965c5f95ab38ce1c55f3</citedby><cites>FETCH-LOGICAL-c532t-439ef64afb47e9249a6de1b02074e423b2edb81d4dbdd965c5f95ab38ce1c55f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/23482223$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/23482223$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,58238,58471</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=26898139$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23024292$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Beinhardt, Sandra</creatorcontrib><creatorcontrib>Rutter, Karoline</creatorcontrib><creatorcontrib>Stättermayer, Albert Friedrich</creatorcontrib><creatorcontrib>Ferenci, Peter</creatorcontrib><title>Revisiting the Predictors of a Sustained Virologic Response in the Era of Direct-Acting Antiviral Therapy for Hepatitis C Virus</title><title>Clinical infectious diseases</title><addtitle>Clin Infect Dis</addtitle><description>Several host (age, sex, race, fibrosis stage, interleukin 28B polymorphism) and viral factors (hepatitis C virus [HCV] genotype, viral load) allow estimating the response to interferon-based therapies (which includes first-generation protease inhibitors) before treatment. However, treatment should not be denied to any patient based on unfavorable factors alone. Metabolic conditions associated with poor response (diabetes, insulin resistance, obesity) and alcohol abuse can be influenced before starting treatment. "On-treatment" predictors of response allow treatment to be tailored to the individual need of the patient. Patients with undetectable HCV RNA after 4 weeks (rapid virologic response [RVR]) have the highest chance for cure (>85%) both by dual and triple therapy. For triple therapy, the decision to shorten treatment requires that the virus remains undetectable for an additional 8 (telaprevir) to 20 (boceprevir) weeks (extended RVR). Based on viral kinetics, an even earlier prediction after 2 weeks of treatment with direct acting antivirals appears feasible.</description><subject>Adult</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiviral agents</subject><subject>Antiviral Agents - therapeutic use</subject><subject>Antiviral drugs</subject><subject>Antivirals</subject><subject>Biological and medical sciences</subject><subject>Chronic hepatitis</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Genotype & phenotype</subject><subject>Genotypes</subject><subject>Hepacivirus</subject><subject>Hepacivirus - drug effects</subject><subject>Hepacivirus - isolation & purification</subject><subject>Hepatitis</subject><subject>Hepatitis C</subject><subject>Hepatitis C - blood</subject><subject>Hepatitis C - drug therapy</subject><subject>Hepatitis C - genetics</subject><subject>Hepatitis C - virology</subject><subject>Hepatitis C virus</subject><subject>Host-Pathogen Interactions</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Infections</subject><subject>Infectious diseases</subject><subject>Insulin resistance</subject><subject>Interferon-alpha - therapeutic use</subject><subject>Interferons</subject><subject>Interleukins - genetics</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Pharmacology. Drug treatments</subject><subject>Polyethylene Glycols - therapeutic use</subject><subject>Polymorphism</subject><subject>Recombinant Proteins - therapeutic use</subject><subject>Ribavirin - therapeutic use</subject><subject>RNA, Viral - blood</subject><subject>Sensitivity and Specificity</subject><subject>Treatment Outcome</subject><subject>Viral diseases</subject><subject>VIRAL HEPATITIS</subject><subject>Viral Load</subject><subject>Virology</subject><subject>Viruses</subject><issn>1058-4838</issn><issn>1537-6591</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNp90c1rFDEYBvAgFltbL96VgAhSGM3nTHJc1mqFgtJWr0MmeafNMjuZJplCT_3Xm-2uVjx4CMnh975P4EHoNSUfKdH8k_WunKQEf4YOqORNVUtNn5c3kaoSiqt99DKlFSGUKiJfoH3GCRNMswN0fw63PvnsxyucrwH_iOC8zSEmHHps8MWcsvEjOPzLxzCEK2_xOaQpjAmwHx9nTqLZ4M8-gs3Vwj4uW4zZ3_poBnx5DdFMd7gPEZ_CZHJJS3i5WTinI7TXmyHBq919iH5-OblcnlZn379-Wy7OKis5y5XgGvpamL4TDWgmtKkd0I4w0ggQjHcMXKeoE65zTtfSyl5L03FlgVope36IPmz3TjHczJByu_bJwjCYEcKcWtpIypgmTV3ou3_oKsxxLL9raV2iKSFMFnW8VTaGlCL07RT92sS7lpJ2U0tbamm3tRT8drdy7tbg_tDfPRTwfgdMsmbooxnL6JOrlVaU6ycX5un_gW-2bpVKl3_lCcUY4_wB_TSssg</recordid><startdate>20130101</startdate><enddate>20130101</enddate><creator>Beinhardt, Sandra</creator><creator>Rutter, Karoline</creator><creator>Stättermayer, Albert Friedrich</creator><creator>Ferenci, Peter</creator><general>Oxford University Press</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7T2</scope><scope>7T7</scope><scope>7U7</scope><scope>7U9</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>P64</scope></search><sort><creationdate>20130101</creationdate><title>Revisiting the Predictors of a Sustained Virologic Response in the Era of Direct-Acting Antiviral Therapy for Hepatitis C Virus</title><author>Beinhardt, Sandra ; Rutter, Karoline ; Stättermayer, Albert Friedrich ; Ferenci, Peter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c532t-439ef64afb47e9249a6de1b02074e423b2edb81d4dbdd965c5f95ab38ce1c55f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Antibiotics. Antiinfectious agents. Antiparasitic agents</topic><topic>Antiviral agents</topic><topic>Antiviral Agents - therapeutic use</topic><topic>Antiviral drugs</topic><topic>Antivirals</topic><topic>Biological and medical sciences</topic><topic>Chronic hepatitis</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Genotype & phenotype</topic><topic>Genotypes</topic><topic>Hepacivirus</topic><topic>Hepacivirus - drug effects</topic><topic>Hepacivirus - isolation & purification</topic><topic>Hepatitis</topic><topic>Hepatitis C</topic><topic>Hepatitis C - blood</topic><topic>Hepatitis C - drug therapy</topic><topic>Hepatitis C - genetics</topic><topic>Hepatitis C - virology</topic><topic>Hepatitis C virus</topic><topic>Host-Pathogen Interactions</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Infections</topic><topic>Infectious diseases</topic><topic>Insulin resistance</topic><topic>Interferon-alpha - therapeutic use</topic><topic>Interferons</topic><topic>Interleukins - genetics</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Pharmacology. 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| fulltext | fulltext |
| identifier | ISSN: 1058-4838 |
| ispartof | Clinical infectious diseases, 2013-01, Vol.56 (1), p.118-122 |
| issn | 1058-4838 1537-6591 |
| language | eng |
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| source | JSTOR Archival Journals and Primary Sources Collection; Oxford Journals Online |
| subjects | Adult Antibiotics. Antiinfectious agents. Antiparasitic agents Antiviral agents Antiviral Agents - therapeutic use Antiviral drugs Antivirals Biological and medical sciences Chronic hepatitis Drug therapy Female Gastroenterology Genotype & phenotype Genotypes Hepacivirus Hepacivirus - drug effects Hepacivirus - isolation & purification Hepatitis Hepatitis C Hepatitis C - blood Hepatitis C - drug therapy Hepatitis C - genetics Hepatitis C - virology Hepatitis C virus Host-Pathogen Interactions Human viral diseases Humans Infections Infectious diseases Insulin resistance Interferon-alpha - therapeutic use Interferons Interleukins - genetics Male Medical sciences Pharmacology. Drug treatments Polyethylene Glycols - therapeutic use Polymorphism Recombinant Proteins - therapeutic use Ribavirin - therapeutic use RNA, Viral - blood Sensitivity and Specificity Treatment Outcome Viral diseases VIRAL HEPATITIS Viral Load Virology Viruses |
| title | Revisiting the Predictors of a Sustained Virologic Response in the Era of Direct-Acting Antiviral Therapy for Hepatitis C Virus |
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