Abstract
In treating hepatitis C infection, identification of reliable markers predicting virological non-response appear central to improving outcome and to prompting changes in dynamic treatment approaches. The interrelationship of ribavirin (RBV) concentrations and laboratory variables with clinical outcomes was evaluated in HCV patients treated with ribavirin, and with or without early direct acting antivirals (DAA). Correlations between RBV concentration, laboratory variables (haemoglobin, absolute lymphocyte, platelet and neutrophil counts, serum creatinine and hepatitis C viral load) and patients’ characteristics associated with sustained virological response (SVR) were investigated using multivariate analysis. The 76 patients studied all received interferon (INF) and RBV, with 37 additionally given Boceprevir or Telaprevir. Significant correlations were noted between week 1 RBV concentration and subsequent total exposure at weeks 2, 4 and 12 (P 30 g/L (week 8) experienced higher SVR rates (P 30 g/L. Six factors were predictive of SVR in univariate analysis, and three in multivariate analysis. There is an association between SVR and absolute lymphocyte count, IL-28B CC genotype, and HCV-RNA load fall at week 1 (>80 %) or week 2 (>90 %) in HCV patients treated with INF/RBV and early DAA.
Highlights
Ribavirin [RBV] (1-[(2R,3R,4S,5R)-3,4-dihydroxy-5(hydroxymethyl)oxolan-2-yl]-1H-1,2,4-triazole-3carboxamide) has remained a valuable adjunctive component of hepatitis C anti-viral therapies despite the shift from interferon-based to direct-acting anti-viral (DAA) regimens [1, 2]
This study examined the features of RBV exposure and their relationship to RBV doses, laboratory variables and outcomes in order to Halina Michur et al.: Ribavirin Concentrations, Laboratory Variables, and Clinical Outcomes During Treatment of Hepatitis C Infection with First Generation Direct-Acting Antivirals distinguish their impact both on the drug’s virological efficacy and its adverse effects
rapid virological response (RVR) was achieved in 32.9% of the overall cohort, early viral response (EVR) in 80.3%, end of treatment response (ETR) in 75% and sustained virological response (SVR) in 53.9%
Summary
Ribavirin [RBV] (1-[(2R,3R,4S,5R)-3,4-dihydroxy-5(hydroxymethyl)oxolan-2-yl]-1H-1,2,4-triazole-3carboxamide) has remained a valuable adjunctive component of hepatitis C anti-viral therapies despite the shift from interferon-based to direct-acting anti-viral (DAA) regimens [1, 2]. Some studies suggest that higher plasma RBV concentrations are associated with a higher rate of sustained virological response (SVR) [9], and that monitoring plasma RBV could be a useful tool to intervene early on in the treatment, allowing necessary dose adjustments to improve tolerability and clinical outcome [10,11,12,13]. This study examined the features of RBV exposure and their relationship to RBV doses, laboratory variables and outcomes in order to Halina Michur et al.: Ribavirin Concentrations, Laboratory Variables, and Clinical Outcomes During Treatment of Hepatitis C Infection with First Generation Direct-Acting Antivirals distinguish their impact both on the drug’s virological efficacy and its adverse effects
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