Chronic hepatitis C genotype 1 treatment roadmap for resource constrained settings

被引:9
作者
Lim, Seng Gee [1 ]
机构
[1] Natl Univ Singapore, Yong Loo Lin Sch Med, Dept Gastroenterol & Hepatol, Dept Med,Natl Univ Hlth Syst, Singapore 119228, Singapore
关键词
Chronic hepatitis C; hepatitis C virus RNA; Sustained virological response; Cirrhosis; Boceprevir; Telaprevir; Response-guided therapy; Peginterferon; Partial responder; Ribavirin; PLUS RIBAVIRIN; ADVANCED FIBROSIS; BOCEPREVIR; ALPHA-2A; THERAPY;
D O I
10.3748/wjg.v21.i6.1972
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
AIM: To use existing hepatitis C virus (HCV) antiviral therapies as access to new treatments is limited. METHODS: A PubMed search for randomised control trials or meta-analysis related to response-guided therapy of HCV genotype 1 patients was undertaken using pegylated interferon and ribavirin (PR), boceprevir (B) and telaprevir (T) and lead-in where response-guided therapy at TW4(TW4), 8(TW8), 10(TW10), or 12(TW12) based on HCVRNA(+) or HCVRNA(-). Studies presented at major conferences were also used. Where necessary, a post-hoc analysis was performed. A response-guided management roadmap was created based on sustained virological response (SVR). RESULTS: Starting with PR, those with HCVRNA(-) at TW4 have > 86% SVR, while those are HCVRNA(+) have 34%-41.7% SVR. HCVRNA(-) TW4 patients can have 24 wk PR if HCVRNA < 400000 IU/mL. Alternatively, 28 wk BPR has similar SVR. If HCVRNA(+) at TW4, 72 wk PR leads to 53% SVR, hence BPR is a better option, and if HCVRNA(-) by TW8, 28 wk therapy is sufficient. If HCVRNA(+) at TW8, then HCVRNA should be checked at TW10 and TW12. By TW12, HCVRNA = 100 IU/mL activates the stopping rule. This roadmap is applicable for treatment-naive, treatment failures and cirrhotic patients. Validation from an Asia Pacific early access boceprevir program confirmed the findings that HCVRNA(-) at TW4, or TW8 conferred > 80% SVR, leading to the "80-80" rule. CONCLUSION: Using a roadmap based on HCVRNA(-) at TW4 or TW8 (the "80-80" rule), high SVR can be achieved, and guide the best choices for treatment, and also reduces drug exposure in poor responders.
引用
收藏
页码:1972 / 1981
页数:10
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[41]   Treatment of chronic hepatitis C [J].
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Colombo, M .
JOURNAL OF BIOLOGICAL REGULATORS AND HOMEOSTATIC AGENTS, 2003, 17 (02) :133-137
[42]   Which therapeutic option for hepatitis C virus genotype 1? [J].
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Duverlie, Gilles .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 2015, 50 (04) :470-478
[43]   Results of the treatment of chronic hepatitis C genotype 4.: A comparative analysis with genotype 1 [J].
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Agreda, M. ;
Devesa, M. J. ;
Cuenca, F. ;
Suarez, A. ;
Ortega, L. ;
Diaz-Rubio, M. ;
Ladero, J. M. .
REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS, 2008, 100 (04) :208-211
[44]   Phase III results of Boceprevir in treatment naive patients with chronic hepatitis C genotype 1 [J].
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[45]   Meloxicam as an adjuvant to peginterferon-α-2a and ribavirin treatment for genotype 1 chronic hepatitis C: A randomized trial [J].
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[47]   Predictors of treatment response in patients with hepatitis C 1b genotype [J].
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Tallo, Tatjana ;
Kuznetsova, Tatiana ;
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Tefanova, Valentina .
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[48]   Sofosbuvir and Ribavirin for Hepatitis C Genotype 1 in Patients With Unfavorable Treatment Characteristics A Randomized Clinical Trial [J].
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Lee, Yu-Jin ;
Bon, Dimitra ;
Heytens, Laura ;
Nelson, Amy ;
Sneller, Michael ;
Kohli, Anita ;
Barrett, Lisa ;
Proschan, Michael ;
Herrmann, Eva ;
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Gu, Wenjuan ;
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Kleiner, David ;
Wood, Brad J. ;
Chavez, Jose ;
Symonds, William T. ;
Subramanian, Mani ;
McHutchison, John ;
Polis, Michael A. ;
Fauci, Anthony S. ;
Masur, Henry ;
Kottilil, Shyamasundaran .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2013, 310 (08) :804-811
[49]   Effect of vitamin D supplementation on pegylated interferon/ribavirin therapy for chronic hepatitis C genotype 1b: a randomized controlled trial [J].
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Kawakami, Y. ;
Hayes, C. N. ;
Kohno, H. ;
Kohno, H. ;
Tsuji, K. ;
Aisaka, Y. ;
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Kitamoto, M. ;
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