Long-Term Outcomes in HCV with SVR Paper

[TnHepGuy_]

This study, looking at long-term outcomes of mono interferon patients, is one that I posted the other day. The topic is one that is of interest to many Hep C patients (myself included), so I figured I'd post it here by itself, along with a some of the highlights from it. There is alot of good data presented here for SVR's.

<a href="http://www.natap.org/2004/HCV/092904_02.htm">Long-Term Outcomes in HCV with SVR: cure, regression of fibrosis</a>


(from the study):

"<i>Long term clinical outcome of chronic hepatitis C patients with sustained virological response to interferon monotherapy: study finds - 29% of SVRs show regression of fibrosis; HCV is curable & long-term outcome of sustained viral responders is good; Five year survival of European sustained virological responders was similar to the general population, matched for age & sex and no HCCs were detected during long term follow up."

"In this study, sustained virological response was associated with a decrease in fibrosis score. Similar findings have been reported for sustained responders to pegylated interferon. Previous studies have shown that regression of fibrosis can also occur in biochemical responders and non-responders to interferon. In common with our study, sustained virological responders show the highest rate of regression. Because of the large proportion of sustained virological responders that showed regression of fibrosis and the low incidence of clinical events in these patients, <b>in our view, non-cirrhotic patients with a sustained virological response can be regarded as cured.</b>"

[lookin-up]

That's so good to hear - same for me....kinda like waking up from a long sleep...life is good & getting better by the day!  I'm waiting for December's final bloodwork.  Still alittle foggy, but then, at 51, that just might be a normal state - I just have fun with it.

My best to ya!!

[lookin-up]

Great article - thanks so much for always keeping us informed !

Hey Chev - we ended treatment about the same time...how are you feeling?

[jonihs]

If you ever figure out what normal is, let me know LOL!!! Thanks for the good wishes and the same back at ya.   Joni

[jonihs]

Hi  Chev- how are you doing. My computer is not working until I can afford the fix it shop, so can only come on at work, but I have missed you and everyone!! I'm doing great. This is the first time in 10 years I've felt up to working, and since I'm working front desk at a hotel and mostly 11PM to 7AM, it's not taxing, so am enjoying it.  Take care. Love, Joni

[DebbieDo]

Hey thats great that you are doing well......I miss hearing from you........I'm approaching the end of tx 41/48......cant wait to get back to normal, whatever normal is...lol

[woodbeegood]

as usual good stuff! i like the fact that they are using "cured" now-that is a real plus! thanks for all the info you provide-it is appreciated! hope you are feeling well!

[Sam Hall]

Thank God for that. After that last limited research that put me in such a spin 'least this is more posative. Thanks again for all your efforts in bringing rerearch to our attention.
Sam Hall with grattitude

[TnHepGuy_]

"<i>A limitation of our study is that all patients had been treated with interferon monotherapy whereas the current standard therapy for chronic hepatitis C is pegylated interferon with ribavirin. This current standard however dates from 2002 and long term follow up data of peginterferon and ribavirin were not available at the time of this study. In general, combination therapy leads to higher sustained virological response rates32,33 and also the late relapse rate seems to decrease. In this study with data on interferon monotherapy, the late relapse rate was 4.7% (95% CI 2.0--7.4); Camma et al reported 8.7% in a meta-analysis of 14 trials with interferon monotherapy. After four years of follow up of treatment with interferon and ribavirin, late virological relapse rates of 3% (95% CI 1.4--4.6) and 1% (95% CI 0--2.0) have been reported for patients treated for 24 weeks and 48 weeks, respectively. After treatment with pegylated interferon with or without ribavirin, a late relapse rate of 0.8% was reported after four years of follow up. The possibility of reinfection could not be ruled out in our cohort as data on risk behaviour and concordance of genotypes were not available. However, introduction of more sensitive PCR methods may also have contributed to a decrease in late virological relapse over time. It is possible that with an insensitive assay, patients with low viraemia are regarded as sustained virological responders.

As the late relapse rate seems to decrease with newer treatment regimens, long term clinical outcomes may be similar or even better than results obtained with interferon monotherapy. Therefore, in our opinion, the favourable clinical outcome of sustained virological responders is likely to hold true in the era of pegylated interferon and ribavirin.

In conclusion, the long term clinical outcome of patients with a sustained response to interferon is favourable. Five year survival of European sustained virological responders was similar to the general population, matched for age and sex, and no HCCs were detected during long term follow up.</i>"



TnHepGuy