Chronic hepatitis C genotype 1 treatment roadmap for resource constrained settings
Copyright policy )Chronic hepatitis C genotype 1 treatment roadmap for resource constrained settings
To use existing hepatitis C virus (HCV) antiviral therapies as access to new treatments is limited.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).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 80% SVR, leading to the "80-80" rule.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.
- National University of Singapore Singapore
- National University Health System Singapore
Time Factors, Genotype, Patient Selection, Hepacivirus, Hepatitis C, Chronic, Viral Load, Antiviral Agents, Drug Costs, Treatment Outcome, Drug Resistance, Viral, Critical Pathways, Humans, RNA, Viral, Drug Therapy, Combination, Delivery of Health Care, Developing Countries, Biomarkers
Time Factors, Genotype, Patient Selection, Hepacivirus, Hepatitis C, Chronic, Viral Load, Antiviral Agents, Drug Costs, Treatment Outcome, Drug Resistance, Viral, Critical Pathways, Humans, RNA, Viral, Drug Therapy, Combination, Delivery of Health Care, Developing Countries, Biomarkers
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