PMID- 19931204
OWN - NLM
STAT- MEDLINE
DCOM- 20100916
LR  - 20181201
IS  - 1600-0641 (Electronic)
IS  - 0168-8278 (Linking)
VI  - 52
IP  - 1
DP  - 2010 Jan
TI  - Shortened treatment duration in treatment-naive genotype 1 HCV patients with 
      rapid virological response: a meta-analysis.
PG  - 25-31
LID - 10.1016/j.jhep.2009.10.003 [doi]
AB  - 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.
FAU - Moreno, Christophe
AU  - Moreno C
AD  - Department of Gastroenterology and Hepatopancreatology, Hopital Erasme, 
      Universite Libre de Bruxelles, Bruxelles, Belgium.
FAU - Deltenre, Pierre
AU  - Deltenre P
FAU - Pawlotsky, Jean-Michel
AU  - Pawlotsky JM
FAU - Henrion, Jean
AU  - Henrion J
FAU - Adler, Michael
AU  - Adler M
FAU - Mathurin, Philippe
AU  - Mathurin P
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
DEP - 20091023
PL  - Netherlands
TA  - J Hepatol
JT  - Journal of hepatology
JID - 8503886
RN  - 0 (Antiviral Agents)
RN  - 0 (Interferon alpha-2)
RN  - 0 (Interferon-alpha)
RN  - 0 (RNA, Viral)
RN  - 0 (Recombinant Proteins)
RN  - 3WJQ0SDW1A (Polyethylene Glycols)
RN  - 49717AWG6K (Ribavirin)
RN  - Q46947FE7K (peginterferon alfa-2a)
SB  - IM
MH  - Antiviral Agents/pharmacology/*therapeutic use
MH  - Dose-Response Relationship, Drug
MH  - Drug Therapy, Combination
MH  - Genotype
MH  - Hepacivirus/*genetics
MH  - Hepatitis C/*drug therapy
MH  - Humans
MH  - Interferon alpha-2
MH  - Interferon-alpha/pharmacology/*therapeutic use
MH  - Polyethylene Glycols/pharmacology/*therapeutic use
MH  - RNA, Viral/genetics
MH  - Recombinant Proteins
MH  - Ribavirin/pharmacology/*therapeutic use
MH  - Time Factors
MH  - Treatment Outcome
MH  - Viral Load/drug effects
EDAT- 2009/11/26 06:00
MHDA- 2010/09/18 06:00
CRDT- 2009/11/26 06:00
PHST- 2009/05/07 00:00 [received]
PHST- 2009/07/13 00:00 [revised]
PHST- 2009/08/03 00:00 [accepted]
PHST- 2009/11/26 06:00 [entrez]
PHST- 2009/11/26 06:00 [pubmed]
PHST- 2010/09/18 06:00 [medline]
AID - S0168-8278(09)00649-7 [pii]
AID - 10.1016/j.jhep.2009.10.003 [doi]
PST - ppublish
SO  - J Hepatol. 2010 Jan;52(1):25-31. doi: 10.1016/j.jhep.2009.10.003. Epub 2009 Oct 
      23.