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SVR after HCV therapy led to long-term clinical cure

Achieving sustained virological response after treatment with pegylated interferon alpha-2b and ribavirin corresponded to a long-term cure for hepatitis C virus infection, according to study data.

“To better understand the clinical importance of residual HCV RNA after SVR, we screened 54 patients 5 [to] 20 years after SVR for HCV RNA traces in plasma, [peripheral blood mononuclear cells] and liver, and performed a full clinical and histological work-up,” the researchers wrote. “In addition, we evaluated humoral and cellular immune responses to HCV in these patients.”

The patients included in the analysis (29 females and 25 males) achieved sustained virologic response (SVR) for chronic HCV after treatment with PEG-IFN a-2b and ribavirin at least 5 years prior to inclusion in the study. Each patient underwent liver biopsy and plasma and peripheral blood mononuclear cells (PBMCs) were tested for HCV RNA at baseline and follow-up to determine clinical, histological, virological and immunological markers 5–20 years after SVR, according to the research.

Overall, 51 patients were HCV RNA-negative in all tissues tested and liver disease regressed significantly in all patients, according to clinical, biological and histological biomarkers. Both alanine aminotransferase and aspartate aminotransferase levels were decreased among the patients from baseline to follow-up (136.78 to 24.14 U/L and 66.66 to 25.14 U/L; P < .0001).

Of the three patients who were not HCV-RNA-negative, all lacked signs of liver disease, all had HCV RNA in PBMCs 5 to 9 years after SVR, HCV-specific T cells and NS3 antibodies, but no cross-neutralizing antibodies, according to the research.

Analyses showed an inverse association between liver disease, HCV-specific T-cell responses and HCV antibody levels with time from SVR.

“Our data indicate that a treatment-induced SVR corresponds to a cure and that the clinical significance of any residual trace amounts of HCV RNA seems limited,” the researchers concluded. – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.