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A Protocol for Analyzing Hepatitis C Virus Replication
Published on: June 26, 2014
Relationship between HCV dynamics and sustained virological responses in chronic hepatitis C genotype 1b patients
Ai Nakagawa1, Masanori Atsukawa, Akihito Tsubota
1aDivision of Gastroenterology, Nippon Medical School Chiba Hokusoh Hospital, Inzai bDivision of Gastroenterology and Hepatology, Shinmatsudo Central General Hospital, Matsudo, Chiba cCore Research Facilities for Basic Science, Research Center for Medical Sciences, Jikei University School of Medicine, Minato-ku dJikei University School of Medicine Katsusika Medical Center, Division of Gastroenterology and Hepatology, Katsushika-ku eDivision of Gastroenterology and Hepatology, Nippon Medical School, Bunkyo-ku, Tokyo, Japan.
Insights
Interleukin 28B (IL28B) genotype TT patients with chronic hepatitis C achieved sustained virological response (SVR) with 24-week treatment when HCV RNA was undetectable by week 8. IL28B non-TT patients required rapid virological response (RVR) for SVR, with extended treatment improving outcomes.
Area of Science:
- Hepatology
- Virology
- Pharmacogenomics
Background:
- Chronic hepatitis C genotype 1b poses a significant global health challenge.
- Telaprevir-based triple therapy has been a key treatment modality.
- Interleukin 28B (IL28B) genetic variations influence treatment response.
Purpose of the Study:
- To investigate the relationship between hepatitis C virus (HCV) dynamics and sustained virological response (SVR).
- To evaluate the efficacy of extended telaprevir-based triple therapy in chronic hepatitis C genotype 1b.
- To analyze the impact of IL28B genotype on treatment outcomes.
Main Methods:
- 220 patients received 24 weeks of triple therapy; SVR rates were analyzed based on HCV RNA undetectability.
- Comparison of SVR rates between patients who achieved rapid virological response (RVR) and those who did not.
- Analysis of SVR rates in 27 patients receiving 48 weeks of triple therapy.
Main Results:
- IL28B TT patients achieved higher SVR rates compared to non-TT patients across all time points.
- All IL28B TT patients with undetectable HCV RNA by week 8 achieved SVR.
- IL28B non-TT patients not achieving RVR had low SVR rates (11.8%) with 24 weeks of treatment, which increased to 62.5% with 48 weeks of treatment (P=0.017).
Conclusions:
- IL28B TT patients can achieve SVR with 24-week treatment if HCV RNA becomes undetectable by week 8.
- IL28B non-TT patients need to achieve RVR for SVR with 24-week treatment.
- Extended treatment to 48 weeks can improve SVR rates in IL28B non-TT patients who do not achieve RVR.
Objectives:
This study investigated the relationship between hepatitis C virus (HCV) dynamics and sustained virological response (SVR), as well as the efficacy of an extended treatment with telaprevir-based triple therapy among patients with chronic hepatitis C genotype 1b.
Methods:
Among 220 patients receiving triple therapy for 24 weeks, the SVR rate was analyzed at each time point at which HCV RNA became undetectable. The SVR rates in the patients who did not achieve a rapid virological response (RVR) were compared with those in 27 patients who received triple therapy for 48 weeks.
Results:
The SVR rates of interleukin 28B (IL28B) TT and non-TT patients were 100 versus 66.7% after 1 week, 97.6 versus 72.2% after 2 weeks, 95.2 versus 84.2% after 3 weeks, 93.1 versus 72.2% after 4 weeks, 76.9% versus 11.1% after 6 weeks, and 88.9 versus 14.3% after 8 weeks, respectively. All of the IL28B TT patients who showed undetectable HCV RNA levels until week 8 achieved an SVR. In contrast, the SVR rates in the IL28B non-TT patients who did not achieve RVR with 24 and 48 weeks of treatment were 11.8 and 62.5%, respectively (P=0.017).
Conclusion:
These results suggest that an SVR can frequently be achieved by IL28B TT patients, even with 24 weeks of treatment, when HCV RNA remains undetectable until week 8, and also that IL28B non-TT patients should have RVR values to achieve an SVR with 24 weeks of treatment. The SVR rate was low in IL28B non-TT patients treated for 24 weeks who did not achieve an RVR; however, it could increase when the treatment duration was extended to 48 weeks.
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