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Journal of Clinical Gastroenterology

Jan 16, 2012 - 0 comments

Journal of Clinical Gastroenterology:

September 2010 - Volume 44 - Issue 8 - pp 583-587

doi: 10.1097/MCG.0b013e3181d7a46c

LIVER, PANCREAS AND BILIARY TRACT: Original Articles

Tailoring Treatment Duration to 12 to 16 Weeks in Hepatitis C Genotype

2 or 3 With Rapid Virologic Response: Systematic Review and Meta-analysis

of Randomized Controlled Trials


Singal, Ashwani K. MD*; Anand, Bhupinder S. MD†

Background and Aims: Current treatment for genotype (GT) 2 or 3 hepatitis C virus infection
is pegylated interferon and ribavirin (RBV) 800 mg/d for 24 weeks. This meta-analysis was
carried out to assess whether the treatment duration can be reduced in patients with rapid
virologic response (RVR)

Methods: Literature was searched for studies comparing short-term (12 to 16 wk) and 24 weeks
treatment in GT 2 or 3 with RVR.

Results: Six studies (n=2434) were included and data on end-of-treatment response (ETR), sustained
virologic response (SVR), and relapse rates (RR) were obtained. Pooled odds ratio (95% CI) for SVR
and RR were 0.54 (0.35-0.85; P=0.008) and 3.12 (1.99-4.91; P<0.00001) favoring 24 weeks of treatment
Reducing treatment duration to 12 to 16 weeks and retreating relapses for 24 weeks was cost-effective.

Conclusions: Reducing treatment duration to 12 to 16 weeks for GT 2 or 3 HCV patients with RVR is
associated with a lower SVR and a higher RR. Advantages of short-term treatment include better
patient compliance, lower rate of adverse effects, and cost. Short-term treatment may be an
option for patients unable to tolerate treatment. Further studies are needed to identify factors
predicting relapse with short-term treatment in GT 2 or 3 patients with RVR.




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