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Predictive factors associated with hepatitis C antiviral therapy response
Lourianne Nascimento Cavalcante1, André Castro Lyra1
1Lourianne Nascimento Cavalcante, André Castro Lyra, Hospital Sao Rafael - Gastro-Hepatology Service, Salvador, Bahia 41253-190, Brazil.
World Journal of Hepatology
|July 4, 2015
Summary
Predictive factors for Hepatitis C virus (HCV) treatment response evolved with new therapies. While early treatments like pegylated interferon plus ribavirin (PR) had identified predictors, newer antiviral drugs offer higher sustained virologic response (SVR) rates, potentially reducing the impact of some factors.
Area of Science:
- Hepatology and Viral Gastroenterology
- Clinical Virology and Infectious Diseases
- Pharmacology and Therapeutics
Background:
- Hepatitis C virus (HCV) infection causes significant liver injury, with disease expression and treatment response influenced by viral, host, and environmental factors.
- The standard of care evolved from dual therapy (pegylated interferon plus ribavirin) to triple therapy with protease inhibitors, and now to direct-acting antiviral agents.
Purpose of the Study:
- To review the evolution of predictive factors for Hepatitis C virus (HCV) treatment response over the past decade.
- To analyze how these factors have changed across different treatment regimens, including older therapies and newer direct-acting antiviral agents.
Main Methods:
- Review of scientific literature and clinical data on HCV treatment regimens from the early 2000s to the present.
- Analysis of viral, host, and environmental factors associated with treatment response, including sustained virologic response (SVR).
- Comparison of predictive factor significance across different therapeutic eras (dual therapy, triple therapy, direct-acting antivirals).
Main Results:
- Early HCV therapies (pegylated interferon plus ribavirin) had identified viral and host predictive factors for treatment response.
- First-generation triple therapies (e.g., with boceprevir or telaprevir) improved SVR but were associated with serious adverse events, highlighting the need for predictive factors.
- Current pangenotypic antiviral therapies demonstrate high SVR rates, suggesting that traditional prognostic factors may have diminished importance, although some variables remain relevant for specific regimens.
Conclusions:
- The landscape of Hepatitis C virus (HCV) treatment has dramatically shifted, with newer antiviral therapies offering superior efficacy and safety profiles.
- While the importance of certain predictive factors has decreased with advanced therapies, understanding remaining variables is crucial for optimizing treatment and minimizing non-response.
- Continued research into predictive markers is essential to personalize HCV treatment strategies and ensure the best outcomes for all patients.
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