Publications & Reports

Short duration response-guided treatment is effective for most individuals with recent hepatitis C infection: the ATAHC II and DARE-C I studies.

Martinello M, Hellard M, Shaw D, Petoumenos K, Applegate T, Grebely J, Yeung B, Maire L, Iser D, Lloyd A, Thompson A, Sasadeusz J, Haber P, Dore GJ, Matthews GV
Viral Hepatitis Clinical Research Program, The Kirby Institute, UNSW Australia, Sydney, NSW, Australia. mmartinello@kirby.unsw.edu.au.

Abstract

BACKGROUND: Individuals with recent hepatitis C virus infection may benefit from shortened duration therapy. These studies evaluated the efficacy and safety of response-guided regimens with pegylated-interferon alfa-2a and ribavirin for people with recent HCV infection. METHODS: Participants with recent hepatitis C (duration of infection </=18months) enrolled in the ATAHC II (pegylated-interferon alfa-2a +/- ribavirin) and DARE-C I (pegylated-interferon alfa-2a, ribavirin and telaprevir) studies were included for analysis. Treatment duration was response-guided (ATAHC II: 8, 16, 24 or 48 weeks; DARE-C I: 8, 12 or 24 weeks) and dependent on time to first undetectable HCV RNA using Roche Taqman HCV RNA testing. The primary efficacy endpoint was SVR12 by intention-to-treat. Logistic regression analyses were used to identify predictors of SVR. RESULTS: Eighty-two participants (62% HIV-positive) were enrolled in ATAHC II (treated, n=52) and 14 (79% HIV-positive) in DARE-C I. The predominant modes of HCV acquisition were injecting drug use (ATAHC II: 55%, DARE-C I: 36%) and sexual intercourse with a partner of the same sex (ATAHC II 39%, DARE-C I 64%). SVR12 was 71% in both ATAHC II (37/52) and DARE-C I (10/14) with 56% in ATAHC II receiving shortened therapy (8 or 16 weeks). SVR was associated with a rapid virological response (odds ratio 10.80; p=0.001). CONCLUSIONS: The majority of participants were able to receive short duration response-guided therapy with pegylated-interferon alfa-2a and ribavirin. Response-guided therapy for recent hepatitis C infection could be considered in the absence of available interferon-free therapies.

Link to publisher’s web site

Publication

  • Journal: Antiviral Therapy
  • Published: 11/02/2016
  • Volume: 21
  • Issue: 5
  • Pagination: 425-434

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Health Issue