Shortened treatment duration in treatment-naive genotype 1 HCV patients with rapid virological response: a meta-analysis.

Détails

ID Serval
serval:BIB_B6C3CEABB35E
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Shortened treatment duration in treatment-naive genotype 1 HCV patients with rapid virological response: a meta-analysis.
Périodique
Journal of Hepatology
Auteur(s)
Moreno C., Deltenre P., Pawlotsky J.M., Henrion J., Adler M., Mathurin P.
ISSN
1600-0641 (Electronic)
ISSN-L
0168-8278
Statut éditorial
Publié
Date de publication
2010
Volume
52
Numéro
1
Pages
25-31
Langue
anglais
Notes
Publication types: Journal Article ; Meta-AnalysisPublication Status: ppublish
Résumé
BACKGROUND & AIMS: In hepatitis C virus genotype 1 (HCV-1) patients with a rapid viral decline within the first month of therapy, a 24-week course of pegylated interferon (PEG-IFN) alpha and ribavirin treatment has been claimed to be as efficient as the standard 48-week duration.
METHODS: We performed a meta-analysis of 7 randomized controlled trials comparing less than 48 weeks to 48 weeks PEG-IFN alpha/ribavirin treatment in 807 HCV-1 patients with rapid viral decline.
RESULTS: SVR was significantly less frequent with short treatment duration than with 48 weeks of therapy, with a mean difference of -13.6% (95% CI: -22.8% to -4.4%, p=0.004). This difference was related to a higher relapse rate (mean difference: 9.9%, 95% CI: 4.1-15.7%, p<0.001). In a sensitivity analysis restricted to studies using only a weight-based ribavirin regimen, shorter therapy was also less efficient. In the subgroup of patients with undetectable HCV-RNA at week 4 and a low baseline HCV-RNA level (400,000 IU/ml), there was no significant difference in SVR rates between 24 and 48 weeks of treatment (mean difference: -3.10%, 95% CI: -8.6% to 2.4%, NS).
CONCLUSIONS: In HCV-1 patients with a rapid virological response, 24 weeks of combination therapy with PEG-IFN alpha and ribavirin should be considered only in subjects with low baseline viral load. However, the optimal cut-off defining low baseline viral load and the impact of the presence of other factors capable of altering treatment response, remain subject to debate.
Mots-clé
Antiviral Agents/pharmacology, Antiviral Agents/therapeutic use, Dose-Response Relationship, Drug, Drug Therapy, Combination, Genotype, Hepacivirus/genetics, Hepatitis C/drug therapy, Humans, Interferon-alpha/pharmacology, Interferon-alpha/therapeutic use, Polyethylene Glycols/pharmacology, Polyethylene Glycols/therapeutic use, RNA, Viral/genetics, Recombinant Proteins, Ribavirin/pharmacology, Ribavirin/therapeutic use, Time Factors, Treatment Outcome, Viral Load/drug effects
Pubmed
Web of science
Création de la notice
06/12/2013 10:12
Dernière modification de la notice
20/08/2019 15:25
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