Sustained virological response (SVR) to hepatitis C treatment
is usually defined as continued undetectable HCV viral load 24
weeks after completion of therapy. Michelle Martinot-Peignoux
and colleagues from France evaluated whether assessment of serum
HCV RNA 12 weeks after the end of treatment was as relevant as
24 weeks for determining SVR.
The investigators analyzed sustained treatment outcomes among
573 chronic hepatitis C patients who received
pegylated interferon (Pegasys or PegIntron) plus ribavirin
and had an end-of-treatment virological response. Viral load was
measured using a sensitive TMA assay with a lower limit of 5-10
IU/mL. Viral relapse was defined as reappearance of detectable
HCV-RNA between the end of treatment and post-treatment week 24.
573 participants had undetectable HCV RNA at the end of treatment.
12 weeks post-treatment, 409 participants still had undetectable
24 weeks post-treatment, 408 participants (71%) achieved SVR.
back at week 12 results, all but 1 of the patients who were
undetectable at week 12 remained so at week 24.
12 response had a positive predictive value of 99.7% for predicting
Week 24 SVR.
researchers concluded that assessment of serum HCV RNA 12 weeks
after the end of treatment using a highly sensitive TMA assay
"is as relevant as after 24 weeks to predict SVR and make
decisions on the management of treated patients, suggesting a
new definition for SVR."
Institut National de la Santé et de la Recherche Médicale,
Centre de Recherche Biomédicale Bichat-Beaujon CRB3, Université
Paris VII, Paris, France; Service d'Hépatologie, Hopital
Beaujon, Clichy, France.
M Martinot-Peignoux, C Stern, S Maylin, and others. Twelve weeks
posttreatment follow-up is as relevant as 24 weeks to determine
the sustained virologic response in patients with hepatitis C
virus receiving pegylated interferon and ribavirin. Hepatology