Classification of virologic responses based on outcomes during and after a 48-week course of pegylated interferon (PEG IFN) plus ribavirin antiviral therapy.

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Classification of virologic responses based on outcomes during and after a 48-week course of pegylated interferon (PEG IFN) plus ribavirin antiviral therapy in patients with hepatitis C, genotype 1 or 4 (for genotype 2 or 3, the course would be 24 weeks). Nonresponders can be classified as null responders (hepatitis C virus [HCV] RNA reduction of <2 log10 IU/mL) or partial responders (HCV RNA reduction ≥2 log10 IU/mL but not suppressed to undetectable) by week 24 of therapy. In responders, HCV RNA can become undetectable, as shown with sensitive amplification assays, within 4 weeks (RVR, rapid virologic response); can be reduced by ≥2 log10 IU/mL within 12 weeks (early virologic response, EVR; if HCV RNA is undetectable at 12 weeks, the designation is “complete” EVR); or at the end of therapy, 48 weeks (ETR, end-treatment response). In responders, if HCV RNA remains undetectable for 24 weeks after ETR, week 72, the patient has a sustained virologic response (SVR), but if HCV RNA becomes detectable again, the patient is considered to have relapsed. The posttreatment week-24 SVR (SVR24) has been supplanted by an SVR at week 12 (SVR12), which has been shown to be equivalent to an SVR24. In patients treated with DAA therapy, RVR and EVR milestones are largely irrelevant, being met by almost all patients. (Reproduced with permission, courtesy of Marc G. Ghany, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health and the American Association for the Study of Liver Diseases. Hepatology 49:1335, 2009.) Source: Chronic Hepatitis, Harrison's Principles of Internal Medicine, 20e Citation: Jameson J, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison's Principles of Internal Medicine, 20e; 2017 Available at: https://accessmedicine.mhmedical.com/DownloadImage.aspx?image=/data/books/2129/hpim20_ch334_f002.png&sec=159214697&BookID=2129&ChapterSecID=159214653&imagename= Accessed: November 10, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved