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HCV viral load levels during treatment and speed of decline do not predict cure with interferon-free therapy
Liz Highleyman, 2015-04-23 07:50:00
Direct-acting antiviral regimens containing sofosbuvir (Sovaldi) and the drugs in Viekirax/Exviera were highly effective regardless of how soon hepatitis C viral load became undetectable after starting treatment, according to research presented at the recent Conference on Retroviruses and Opportunistic Infections (CROI 2015). Furthermore, even having low-level detectable HCV RNA at the end of treatment does not preclude a cure, the investigators for a related study concluded.
The advent of direct-acting antiviral agents (DAAs) that interfere with various steps of the hepatitis C virus lifecycle has revolutionised hepatitis C treatment and allowed interferon-free therapy. The outgoing standard of care, pegylated interferon plus ribavirin, lasted 6-12 months, caused difficult side-effects and only cured about half of people who were treated.
When using interferon-based therapy, hepatitis C viral load or HCV RNA level was monitored over the course of therapy – typically from 4 weeks after starting treatment to 24 weeks after its completion – to allow people without adequate viral suppression to discontinue treatment that was likely to be futile, sparing them months of adverse effects. But the value of viral load monitoring has not been demonstrated for interferon-free therapy, which typically lasts 3-6 months, is well-tolerated and cures hepatitis C for upwards of 90% of people treated.
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