| Very early prediction of response to HCV treatment with PEG-IFN-alfa-2a and ribavirin in HIV/HCV-coinfected patients. | |
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MedLine Citation:
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PMID: 20738775 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The objective of this study was to find very early viral kinetic markers to predict nonresponse to hepatitis C virus (HCV) therapy in a group of human immunodeficiency virus (HIV)/HCV-coinfected patients. Twenty-six patients (15 HCV genotype-1 and 11 genotype-3) were treated with a 48-week regimen of peginterferon-alfa-2a (PEG-IFN) (180 μg/week) and weight-based ribavirin (11 mg/kg/day). Samples were collected at baseline; 4, 8, 12, 18, 24, 30, 36 and 42 h; days 2, 3, 4, 7, 8, 15, 22, 29, 43 and 57 then weekly and monthly. Five patients discontinued treatment. Seven patients (27%) achieved a sustained virological response (SVR). Nadir HCV RNA levels were observed 1.6 ± 0.3 days after initiation of therapy, followed by a 0.3- to 12.9-fold viral rebound until the administration of the second dose of PEG-IFN, which were not associated with SVR or HCV genotype. A viral decline <1.19 log for genotype-1 and <0.97 log for genotype-3, 2 days after starting therapy, had a negative predictive value (NPV) of 100% for SVR. The day 2 virological response had a similar positive predictive value for SVR as a rapid virological response at week 4. In addition, a second-phase viral decline slope (i.e., measured from day 2 to 29) <0.3 log/week had a NPV = 100% for SVR. We conclude that first-phase viral decline at day 2 and second-phase viral decline slope (<0.3 log/week) are excellent predictors of nonresponse. Further studies are needed to validate these viral kinetic parameters as early on-treatment prognosticators of nonresponse in patients with HCV and HIV. |
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Authors:
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E S A Araújo; H Dahari; A U Neumann; N de Paula Cavalheiro; C E Melo; E S de Melo; T J Layden; S J Cotler; A A Barone |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of viral hepatitis Volume: 18 ISSN: 1365-2893 ISO Abbreviation: J. Viral Hepat. Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-03-11 Completed Date: 2011-06-20 Revised Date: 2012-04-04 |
Medline Journal Info:
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Nlm Unique ID: 9435672 Medline TA: J Viral Hepat Country: England |
Other Details:
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Languages: eng Pagination: e52-60 Citation Subset: IM |
Copyright Information:
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© 2010 Blackwell Publishing Ltd. |
Affiliation:
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University of São Paulo Hospital das Clínicas, Infectious Diseases Department-Hepatitis Unit, São Paulo, Brazil. evaldostanislau@uol.com.br |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antiviral Agents / administration & dosage* Female HIV Infections / complications* Hepatitis C / drug therapy* Humans Interferon-alpha / administration & dosage* Male Middle Aged Polyethylene Glycols / administration & dosage* Prognosis RNA, Viral / blood Recombinant Proteins Ribavirin / administration & dosage* Treatment Outcome Viral Load |
| Grant Support | |
ID/Acronym/Agency:
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P20 RR018754-06A1/RR/NCRR NIH HHS; P20-RR018754/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Antiviral Agents; 0/Interferon-alpha; 0/Polyethylene Glycols; 0/RNA, Viral; 0/Recombinant Proteins; 0/peginterferon alfa-2a; 36791-04-5/Ribavirin; 76543-88-9/interferon alfa-2a |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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