%0 Journal Article
%A Pineda, J. A.
%A Morano-Amado, L. E.
%A Granados, R.
%A Macias, J.
%A Tellez, F.
%A Garcia-Deltoro, M.
%A Rios, M. J.
%A Collado, A.
%A Delgado-Fernandez, M.
%A Suarez-Santamaria, M.
%A Serrano, M.
%A Miralles-Alvarez, C.
%A Neukam, K.
%T Week 4 response predicts sustained virological response to all-oral direct-acting antiviral-based therapy in cirrhotic patients with hepatitis C virus genotype 3 infection
%D 2017
%@ 1198-743X
%U http://hdl.handle.net/10668/18752
%X Objective: The aim of this study was to determine the predictive capacity of response at treatment week (TW) 4 for the achievement of sustained virological response 12 weeks after the scheduled end of therapy date (SVR12) to treatment against hepatitis C virus (HCV) genotype 3 (GT3) infection with all-oral direct-acting antiviral (DAA) -based regimens.Patients and methods: From a prospective multicohort study, HCV GT3-infected patients who completed a course of currently recommended DAA-based therapy at 33 Spanish hospitals and who had reached the SVR12 evaluation time-point were selected. TW4 HCV-RNA levels were categorized as target-notdetected (TND), below the lower limit of quantification (LLOQTD) and >= LLOQ.Results: A total of 123 patients were included, 86 (70%) received sofosbuvir/ daclatasvir +/- ribavirin, 27 (22%) received sofosbuvir/ ledipasvir/ ribavirin and 10 (8.1%) received sofosbuvir/ ribavirin, respectively. In all, 114 (92.7%) of the 123 patients presented SVR12 in an on-treatment approach, but nine (7.3%) patients relapsed, all of them had presented cirrhosis at baseline. In those who achieved TND, LLOQTD and >= LLOQ, SVR12 was observed in 81/83 (98%; 95% CI 91.5%-99.7%), 24/28 (85.7%; 95% CI 67.3%-96%) and 9/12 (75%; 95% CI 42.8%-94.5%), respectively; p(linear association) 0.001. Corresponding numbers for subjects with cirrhosis were: 52/54 (96.3%; 95% CI 87.3%-95.5%), 14/ 18 (77.8%; 95% CI 52.4%-93.6%) and 7/10 (70%; 95% CI 34.8%-93.3%); p 0.004.Conclusions: TW4-response indicates the probability of achieving SVR12 to currently used DAA-based therapy in HCV genotype 3-infected individuals with cirrhosis. This finding may be useful to tailor treatment strategy in this setting. 
%K Cirrhosis
%K Direct-acting antivirals
%K Hepatitis C virus genotype 3
%K Interferon-free regimens
%K Sustained virological response
%K Viral kinetics
%K Área de Gestión Sanitaria Campo de Gibraltar Oeste
%K Área de Gestión Sanitaria Sur de Sevilla
%~