HCV Genotype 1 Patients with High Viral Load Do Better with 48 vs 24 Weeks of
Treatment, despite Rapid Virological Response
•
Overall, the
48-week treatment arm had a significantly higher SVR rate compared with the 24-week
arm (79% vs 59%; P = 0.002).
•
For 87 patients
(43.5%) who achieved RVR, the 48-week arm also had a higher SVR rate than the
24-week arm (100% vs 88.9%; P = 0.056).
•
For 52 patients
with low baseline HCV RNA viremia (< 400,000 IU/mL) and RVR, however, the 24-week
arm had an SVR rate of 96.4%, which was comparable to the 100% rate seen in the
48-week arm.
•
Stated another
way, relapse rates after completion of treatment were statistically similar in
the low baseline viral load group, whether they were treated for 24 weeks (3.6%)
or 48 weeks (0%).
•
Multivariate
analysis of all patients showed that RVR was the strongest independent predictor
of SVR, followed by treatment duration, mean weight-based exposure to ribavirin,
and baseline HCV viral load.
Based
on these findings, the study authors concluded that, "HCV[genotype]-1 patients
derive a significantly better SVR from 48 weeks versus 24 weeks of peginterferon/ribavirin
even if they attain an RVR."
They added, however, that, "Both
24 and 48 weeks of therapy can achieve high SVR rates (> 96%) in HCV[genotype]-1
patients with low viral loads and an RVR."
 Kaohsiung
Medical University Hospital, Kaohsiung, Taiwan; Kaohsiung Municipal Hsiao-Kang
Hospital, Kaohsiung, Taiwan; Paochien Hospital, Pintung, Taiwan. 7/04/08 Reference
ML
Yu, CY Dai, JF Huang, and others. Rapid virological response and treatment duration
for chronic hepatitis C genotype 1 patients: a randomized trial. Hepatology
47(6): 1884-1893. June 2008. [ Abstract
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