May some HCV genotype 1 patients still benefit from dual therapy? The role of very early HCV kinetics

Monica Tontodonati, Valeria Cento, Ennio Polilli, Cecilia Colabattista, Raffaella Cascella, Maria Pina Sciotti, Dante Di Giammartino, Francesca Trave, Velia Chiara Di Maio, Roberto Monarca, Francesco Di Candilo, Roberta Prinapori, Elena Rastrelli, Jacopo Vecchiet, Francesca Ceccherini-Silberstein, Lamberto Manzoli, Emiliano Giardina, Carlo Federico Perno, Giustino Parruti

Research output: Contribution to journalArticlepeer-review

Abstract

When treating HCV patients with conventional dual therapy in the current context of rapidly evolving HCV therapy, outcome prediction is crucial and HCV kinetics, as early as 48 hours after the start of treatment, may play a major role. We aimed at clarifying the role of HCV very early kinetics. We consecutively enrolled mono-infected HCV patients at 7 treatment sites in Central Italy and evaluated the predictive value of logarithmic decay of HCV RNA 48 hours after the start of dual therapy (Delta48). Among the 171 enrolled patients, 144 were evaluable for early and sustained virological response (EVR, SVR) prediction; 108 (75.0%) reached EVR and 84 (58.3%) reached SVR. Mean Delta48 was 1.68±1.22 log10 IU/ml, being higher in patients with SVR and EVR. Those genotype-1 patients experiencing a Delta48 >2 logs showed a very high chance of success (100% positive predictive value), even in the absence of rapid virological response (RVR). Evaluation of very early HCV kinetics helped identify a small but significant proportion of genotype-1 patients (close to 10%) in addition to those identified with RVR, who could be treated with dual therapy in spite of not reaching RVR. In the current European context, whereby sustainability of HCV therapy is a crucial issue, conventional dual therapy may still play a reasonable role in patients with good tolerance and early prediction of success.

Original languageEnglish
Pages (from-to)491-497
Number of pages7
JournalNew Microbiologica
Volume38
Issue number4
Publication statusPublished - Oct 1 2015

Keywords

  • Early viral kinetics
  • EVR
  • HCV dual therapy
  • HCV therapy optimization
  • RVR

ASJC Scopus subject areas

  • Microbiology (medical)

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