title: "12 weeks' stopping rule" in the treatment of genotype 1 chronic hepatitis C: two prognostic categories under the same label?
abstract: OBJECTIVE
  The current guidelines recommend maintenance of combined therapy for hepatitis C virus (HCV) genotype-1 chronic hepatitis when HCV-RNA is undetectable or < or = 2 log10 of baseline after 12 weeks of therapy. The aim of this study was to investigate whether the probability of obtaining sustained viral (SVR) response is similar when HCV-RNA is undetectable or is present at < or = 2 log10 level after 12 weeks of therapy.
  
  
  METHODS
  Retrospective analysis was carried out in 208 HCV genotype-1 chronic hepatitis patients treated with pegylated interferon and ribavirin with available data on HCV viral load after 12 weeks of therapy and definite data on the results of therapy.
  
  
  RESULTS
  Seventy-six (68.5%) out of 111 patients with undetectable HCV-RNA and 4 (11.8%) out of 34 patients with HCV-RNA < or = 2 log10 from baseline at week 12 reached SVR (odds ratio 16.29, 95% CI 5.08-67.12; p < 0.001). Sixty-three patients did not meet any of these criteria and therapy was discontinued.
  
  
  CONCLUSIONS
  The "12-week stopping rule" includes two different categories of responders considered candidates for maintained therapy, but the probability of obtaining SVR is very low in patients with HCV-RNA that is still detectable at this time of treatment. We suggest that, in these partial responders, the prolongation of therapy should be decided on an individual basis.
authors.affiliation: Department of Gastroenterology , Hospital Clinico San Carlos, Complutense University, Madrid, Spain. jladero.hcsc@salud.madrid.org
authors.forename: José M
authors.initials: JM
authors.lastname: Ladero
authors.forename: Gustavo
authors.initials: G
authors.lastname: López-Alonso
authors.forename: María J
authors.initials: MJ
authors.lastname: Devesa
authors.forename: Francisca
authors.initials: F
authors.lastname: Cuenca
authors.forename: Marta
authors.initials: M
authors.lastname: Agreda
authors.forename: Luis
authors.initials: L
authors.lastname: Ortega
authors.forename: Avelina
authors.initials: A
authors.lastname: Suárez
authors.forename: Manuel
authors.initials: M
authors.lastname: Díaz-Rubio
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D004337:Drug Carriers; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011379:Prognosis; D012367:RNA, Viral / Q000235:genetics*; D011994:Recombinant Proteins; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012254:Ribavirin / Q000627:therapeutic use; D013997:Time Factors
chemical_list: D000998:Antiviral Agents; D004337:Drug Carriers; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a