Response-guided therapy for acute hepatitis C: applying concepts from chronic treatment.

摘要

Each year, 17000 individuals in the United States are infected with the hepatitis C virus (HCV), with the majority developing chronic infection (1). Current guidelines recommend treatment of acute HCV with interferon-based therapy, with a suggested duration of 12-24 weeks (2). This approach has proven effective in producing a sustained virological response (SVR) (3). Important predictors of SVR include a rapid virological response (RVR; absent HCV RNA at treatment week 4) and/or early virological response (EVR; absent RNA at week 12). While between 85 and 100% of patients will meet these thresholds (4, 5), it is unclear how to optimally treat patients who fail to demonstrate favourable viral kinetics. We applied response-guided therapy, adapted from studies in chronic HCV infection, to successfully treat a patient with acute HCV and a slow virological response to therapy.