TY - JOUR
T1 - 'Easy to treat' genotypes were not created equal
T2 - Can rapid virological response (RVR) level the playing field?
AU - Duarte-Rojo, Andres
AU - Heathcote, Elizabeth Jenny
AU - Feld, Jordan Jay
N1 - Funding Information:
Andrés Duarte-Rojo receives funding for a Clinical Fellowship from the Instituto de Ciencia y Tecnología del Distrito Federal, ICyTDF (México), and The American College of Gastroenterology, ACG: International Training Grant 2009 (USA).
PY - 2011/8
Y1 - 2011/8
N2 - Genotypes 2 and 3 (G2/G3) of hepatitis C virus have been lumped together as 'easy to treat'. As a result, guidelines recommend 24 weeks of peginterferon/ribavirin for both. However, a closer look at trials shows that these genotypes are not the same, with G2 infection proving more responsive to peginterferon. The data supporting this conclusion are presented along with possible explanations for the differences observed. Ultimately, decisions must be made about therapy. Rapid virological response (RVR) may be the best parameter predicting successful antiviral therapy. For patients with G2 infection who achieve an RVR, shortened courses of therapy are effective. In contrast, for G3 patients without an RVR, there may be benefit to extending therapy to 48 weeks; however, this requires confirmation in prospective studies. Using RVR to guide therapy may level the playing field between these 'easy to treat' genotypes.
AB - Genotypes 2 and 3 (G2/G3) of hepatitis C virus have been lumped together as 'easy to treat'. As a result, guidelines recommend 24 weeks of peginterferon/ribavirin for both. However, a closer look at trials shows that these genotypes are not the same, with G2 infection proving more responsive to peginterferon. The data supporting this conclusion are presented along with possible explanations for the differences observed. Ultimately, decisions must be made about therapy. Rapid virological response (RVR) may be the best parameter predicting successful antiviral therapy. For patients with G2 infection who achieve an RVR, shortened courses of therapy are effective. In contrast, for G3 patients without an RVR, there may be benefit to extending therapy to 48 weeks; however, this requires confirmation in prospective studies. Using RVR to guide therapy may level the playing field between these 'easy to treat' genotypes.
KW - Genotypes
KW - Hepatitis C virus
KW - Insulin resistance
KW - Peginterferon
KW - Prognostic factors
KW - Ribavirin
KW - Viral kinetics
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U2 - 10.1016/j.jhep.2011.02.004
DO - 10.1016/j.jhep.2011.02.004
M3 - Review article
C2 - 21334393
AN - SCOPUS:79960454674
SN - 0168-8278
VL - 55
SP - 466
EP - 473
JO - Journal of Hepatology
JF - Journal of Hepatology
IS - 2
ER -
