Hepatitis C (cont.)

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What are the different patterns of response to antiviral treatment?

Treatment responses are mainly defined by results of the HCV RNA testing. Four patterns of response to antiviral treatment have been described:

  1. sustained virologic response,
  2. relapse,
  3. partial response, and
  4. no response.

Sustained virologic response: The optimal response is a sustained virologic response (SVR), defined as the absence of detectable HCV RNA in serum using a sensitive test at the end of the treatment and six months later. Most of these individuals will remain in remission (no signs of the disease) indefinitely, with no detectable hepatitis C virus RNA in the blood or liver. Moreover, follow-up biopsies show a marked reduction in inflammation and there even can be regression of scarring. Longer follow-up of these patients is necessary, however, to evaluate definitively whether sustained responders will avoid the complications of cirrhosis and live longer.

Relapse: Relapsers are patients who initially eliminate the RNA from their blood but then develop detectable RNA again shortly after discontinuing therapy. The RNA becomes detectable again within six months and usually within the first three months of stopping treatment.

Partial responders: Patients whose HCV RNA levels decline (two log decrease) but never become undetectable at 24 weeks are referred to as partial responders.

No response: Patients who have sustained levels of detectable HCV RNA during therapy are known as non-responders. Patients in whom HCV RNA becomes undetectable during the early period of treatment but reappears before the end of therapy, should probably likewise be considered non-responders. This reappearance of HCV RNA during therapy is referred to as a 'break through' of HCV.

Medically Reviewed by a Doctor on 2/2/2014

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