This uncommissioned review article was subject to full peer-review.
Review article: the role of rapid virological response in determining treatment duration for chronic hepatitis C
Article first published online: 17 MAR 2010
© 2010 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 31, Issue 12, pages 1251–1267, June 2010
How to Cite
POORDAD, F. F. (2010), Review article: the role of rapid virological response in determining treatment duration for chronic hepatitis C. Alimentary Pharmacology & Therapeutics, 31: 1251–1267. doi: 10.1111/j.1365-2036.2010.04300.x
- Issue published online: 20 MAY 2010
- Article first published online: 17 MAR 2010
- Publication data Submitted 11 December 2009 First decision 24 December 2009 Resubmitted 22 February 2010 Accepted 10 March 2010 Epub Accepted Article 17 March 2010
Aliment Pharmacol Ther 31, 1251–1267
Background For patients with chronic hepatitis C, attaining rapid virological response (RVR) is highly predictive of attaining SVR.
Aim To consider the predictive value of RVR in terms of SVR and relapse.
Methods Data were collected from published clinical trials to define the predictive value of RVR for SVR and evaluate the proposed continuum linking RVR to relapse.
Results These data support a 24-week regimen among genotype (G)1 patients who attain RVR with positive predictive values (PPVs) of 77.8% and 85.7% in patients with G1 infection treated for 24 and 48 weeks. Conversely, failure to attain RVR among G1 patients should not be viewed as a criterion for extending treatment duration beyond 48 weeks: negative predictive values (NPVs) were 60.9% and 52.7% in G1 patients without RVR treated for 48 and 72 weeks. Among G2/3 patients, RVR has a high PPV; however, the NPV varied with treatment duration indicating that a 24-week treatment regimen is warranted in G2/3 patients who fail to attain RVR.
Conclusions The present analysis confirms RVR as a strong predictor of SVR that can be used to tailor treatment duration, but which also should be appreciated in the context of treatment duration and regimen.