| Sustained
Virological Response (SVR) Rates and Durability in a Clinical Setting  Controlled
clinical trials of pegylated interferon plus
ribavirin have yielded sustained virological
response (SVR) rates ranging from about 40% to 80%, depending on genotype,
significantly higher than the 6% to 20% rate obtained with conventional
interferon monotherapy. Response rates in actual clinical practice, however,
are often lower than those observed in clinical trials.
In
the May 2006 Journal of Viral Hepatitis, researchers reported on a study
looking at response rates and durability in a clinical setting. They analyzed
data from 1540 chronic hepatitis C patients, 344 of whom received interferon-based
therapy for at least 12 weeks: 
175 received conventional
interferon monotherapy
96 received conventional interferon plus ribavirin
73 received pegylated interferon plus ribavirin.
Results
Conventional
interferon monotherapy was associated with an SVR rate of 5% in patients with
genotype 1 HCV and 25% in patients with genotype 2 or 3.
SVR rates were higher (P < 0.001) using conventional
interferon plus ribavirin: 41% for genotype
1 and 73% for genotypes
2 or 3
Rates were also higher (P < 0.001) using pegylated
interferon plus ribavirin, at 47% and 79%, respectively.
After a mean follow-up period of 2.3 years (range 0.3-10.3), all but one of 147
patients who achieved SVR (> 99%) still had undetectable HCV viral load.
Conclusion Advances
in therapy have led to higher sustained response rates in hepatitis C patients
treated in the clinical setting, the authors concluded, and "We can now expect
an SVR in over half of the treated patients." They suggested that since response
appears durable, "medium and long-term follow-up of patients are of low yield
and largely unnecessary." 6/30/06 Reference
CP
Desmond, SK Roberts, F Dudley, and others. Sustained virological response rates
and durability of the response to interferon-based therapies in hepatitis C patients
treated in the clinical setting. Journal of Viral Hepatitis. 13(5): 1311-1315.
May 2006.
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