Effect of Low Positive End of Treatment Viral Load with Direct-Acting Antiviral Therapy on Sustained Virologic Response.
Journal
Canadian journal of gastroenterology & hepatology
ISSN: 2291-2797
Titre abrégé: Can J Gastroenterol Hepatol
Pays: Egypt
ID NLM: 101623613
Informations de publication
Date de publication:
2020
2020
Historique:
received:
04
03
2020
revised:
23
06
2020
accepted:
01
07
2020
entrez:
18
8
2020
pubmed:
18
8
2020
medline:
12
8
2021
Statut:
epublish
Résumé
Direct-acting antivirals (DAAs) are highly effective treatments against hepatitis C virus (HCV), with sustained virologic response (SVR) rates of 93-100% against all genotypes. In most patients, viral load (VL) becomes undetectable four weeks into treatment, but rarely a low positive VL may be observed at the end of treatment (EOT). This study was conducted to determine the effect of low positive EOT VLs with DAA therapies on SVR at 12 and 24 weeks. A retrospective chart review was conducted from January 2014 to December 2018 on 1256 HCV patients of all genotypes (1-6) who had received DAA therapy at two large hepatology referral centers. Baseline demographic data, along with VL at week four, EOT, and SVR12/24 time points were collected for patients that had positive EOT VL. Treatment outcome for any patient with positive EOT VL was noted. Eight out of 1256 patients treated with varying DAA therapies were observed to have low positive EOT VLs ranging from <15 to 235 IU/mL. One patient had a negative EOT VL, but 23 IU/mL at week four after EOT. All eight patients who had low positive EOT VLs and one patient who had a low positive VL at four weeks after EOT achieved SVR at weeks 12 and 24. One of the eight patients had cirrhosis. The majority of patients were genotype 1a. In the DAA treatment era, low levels of detectable HCV RNA at EOT does not predict treatment failure.
Sections du résumé
Background
Direct-acting antivirals (DAAs) are highly effective treatments against hepatitis C virus (HCV), with sustained virologic response (SVR) rates of 93-100% against all genotypes. In most patients, viral load (VL) becomes undetectable four weeks into treatment, but rarely a low positive VL may be observed at the end of treatment (EOT). This study was conducted to determine the effect of low positive EOT VLs with DAA therapies on SVR at 12 and 24 weeks.
Methods
A retrospective chart review was conducted from January 2014 to December 2018 on 1256 HCV patients of all genotypes (1-6) who had received DAA therapy at two large hepatology referral centers. Baseline demographic data, along with VL at week four, EOT, and SVR12/24 time points were collected for patients that had positive EOT VL. Treatment outcome for any patient with positive EOT VL was noted.
Results
Eight out of 1256 patients treated with varying DAA therapies were observed to have low positive EOT VLs ranging from <15 to 235 IU/mL. One patient had a negative EOT VL, but 23 IU/mL at week four after EOT. All eight patients who had low positive EOT VLs and one patient who had a low positive VL at four weeks after EOT achieved SVR at weeks 12 and 24. One of the eight patients had cirrhosis. The majority of patients were genotype 1a.
Conclusion
In the DAA treatment era, low levels of detectable HCV RNA at EOT does not predict treatment failure.
Identifiants
pubmed: 32802821
doi: 10.1155/2020/8815829
pmc: PMC7403896
doi:
Substances chimiques
Antiviral Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
8815829Informations de copyright
Copyright © 2020 Vabhave Pal et al.
Déclaration de conflit d'intérêts
Apurva Modi is a speaker for Gilead Sciences, AbbVie, Dova Pharmaceuticals, Salix Pharmaceuticals, and Intercept Pharmaceuticals. Vabhave Pal, Nirupama Ancha, and Jena Mann have no conflicts of interest to disclose.
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