title: Durability of SVR in chronic hepatitis C patients treated with peginterferon-α2a/ribavirin in combination with a direct-acting anti-viral.
abstract: BACKGROUND
  The introduction of direct-acting anti-virals has increased sustained virological response (SVR) rates in chronic hepatitis C genotype 1 infection. At present, data on long-term durability of viral eradication after successful triple therapy are lacking.
  
  
  OBJECTIVE
  To evaluate the long-term durability of viral eradication in patients treated with triple therapy, including direct-acting anti-virals.
  
  
  METHODS
  Patients who participated in randomised, controlled trials or an extended access programme of treatment with peginterferon-α2a/ribavirin in combination with a direct-acting anti-viral (telaprevir, danoprevir, faldaprevir, simeprevir, mericitabine, balapiravir) were followed after achieving SVR. The median follow-up after the patients was 21 (range: 7-64) months.
  
  
  RESULTS
  One hundred and three patients with chronic hepatitis C genotype 1 infection [f/m: 34/69; GT-1b: 67 GT-1a: 34, GT-4: 2; mean age: 47.6 years (45.5-49.7; 95% CI)] achieving a SVR triple therapy were followed. Two cases of late relapses (2/103, 1.9%; 95% CI: 0.24-6.8) were observed. One patient was cirrhotic, both carried the genotype 1b and completed the prescribed treatment. The relapses occurred 8 and 12 months after cessation of anti-viral treatment. Cloning sequencing revealed identical sequence in both patients. Resistance analysis revealed no presence of viral resistance.
  
  
  CONCLUSIONS
  Like the SVR after peginterferon-α2/ribavirin combination treatment, HCV eradication after triple therapy remains durable after long-term follow-up.
authors.affiliation: Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.
authors.forename: K
authors.initials: K
authors.lastname: Rutter
authors.forename: H
authors.initials: H
authors.lastname: Hofer
authors.forename: S
authors.initials: S
authors.lastname: Beinhardt
authors.forename: M
authors.initials: M
authors.lastname: Dulic
authors.forename: M
authors.initials: M
authors.lastname: Gschwantler
authors.forename: A
authors.initials: A
authors.lastname: Maieron
authors.forename: H
authors.initials: H
authors.lastname: Laferl
authors.forename: A F
authors.initials: AF
authors.lastname: Stättermayer
authors.forename: T-M
authors.initials: TM
authors.lastname: Scherzer
authors.forename: R
authors.initials: R
authors.lastname: Strassl
authors.forename: H
authors.initials: H
authors.lastname: Holzmann
authors.forename: P
authors.initials: P
authors.lastname: Steindl-Munda
authors.forename: P
authors.initials: P
authors.lastname: Ferenci
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D016174:Hepacivirus / Q000502:physiology; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000235:genetics / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a