Characterization of nonrapid virologic response patients infected with HCV genotype 1 who may relapse after standard therapy with peginterferon plus ribavirin

N. Reau, F. M. Hamzeh, E. Lentz, X. Zhou, D. Jensen

Research output: Contribution to journalArticle

Abstract

Approximately 50% of patients with hepatitis C virus (HCV) genotype 1 treated with peginterferon alfa-2a/ribavirin discontinue treatment early or experience a suboptimal response despite 48 weeks of therapy. The objective of this analysis was to develop a model to identify nonrapid virologic response (non-RVR) patients who may be candidates for intensified therapy that would increase treatment response. The retrospective analysis included non-RVR patients from four trials of 48-week peginterferon alfa-2a/ribavirin treatment. Patients were grouped into those who cleared virus between weeks 5 and 12 (complete early virologic responders, cEVR) or between weeks 13 and 24 (slow responders). A model was developed to predict relapse at the end of follow-up (week 72). An optimal model was evaluated and compared with current practice by using receiver operating characteristic curves, sensitivity and specificity. In total, 539 non-RVR patients were eligible for analysis of which 72% experienced cEVR and 28% were slow responders. Variables associated with relapse included age, ethnicity, baseline HCV RNA and interval of time to HCV RNA undetectable. The optimal model was most accurate at predicting patients at risk for relapse. The practice of considering treatment intensification (e.g. extending treatment duration) in all slow responders was less accurate but likely most practical. A week 4 HCV

Original languageEnglish (US)
Pages (from-to)94-102
Number of pages9
JournalJournal of Viral Hepatitis
Volume19
Issue number2
DOIs
StatePublished - Feb 2012
Externally publishedYes

Keywords

  • genotype 1
  • hepatitis C virus
  • peginterferon
  • predictive model
  • relapse
  • ribavirin

ASJC Scopus subject areas

  • Hepatology
  • Infectious Diseases
  • Virology

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