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'Easy to treat' genotypes were not created equal: can rapid virological response (RVR) level the playing field?
Andres Duarte-Rojo1, Elizabeth Jenny Heathcote, Jordan Jay Feld
1Liver Centre, Toronto Western Hospital, University Health Network/University of Toronto, 399 Bathurst St., 6B Fell Pavilion, Room 158, Toronto, Ontario, Canada M5T 2S8.
Abstract:
Genotypes 2 and 3 (G2/G3) of hepatitis C virus have been lumped together as 'easy to treat'. As a result, guidelines recommend 24 weeks of peginterferon/ribavirin for both. However, a closer look at trials shows that these genotypes are not the same, with G2 infection proving more responsive to peginterferon. The data supporting this conclusion are presented along with possible explanations for the differences observed. Ultimately, decisions must be made about therapy. Rapid virological response (RVR) may be the best parameter predicting successful antiviral therapy. For patients with G2 infection who achieve an RVR, shortened courses of therapy are effective. In contrast, for G3 patients without an RVR, there may be benefit to extending therapy to 48 weeks; however, this requires confirmation in prospective studies. Using RVR to guide therapy may level the playing field between these 'easy to treat' genotypes.
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