Selecting a Treatment Regimen
Table 3. Definitions of Virological Responses Virological Response Definition
Rapid virological response (RVR)
Extended rapid virological response (eRVR)
Early virological response (EVR)
End-of-treatment response (ETR)
Sustained virological response (SVR)
Breakthrough Relapse
Non-responder Null responder
Partial responder
Special Cases Acute Hepatitis C
ÎPatients with acute HCV infection should be considered for interferon- based anti-viral therapy (I-B).
ÎTreatment can be delayed for 8 to 12 weeks after acute onset of hepatitis to allow for spontaneous resolution (IIa-B).
ÎAlthough excellent results were achieved using standard interferon monotherapy, it is appropriate to consider the use of PegIFN because of its greater ease of administration (I-B).
ÎUntil more information becomes available, no definitive recommendation can be made about the optimal duration needed for treatment of acute HCV. However, it is reasonable to treat for at least 12 weeks, and 24 weeks may be considered (IIa-B).
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HCV RNA negative at treatment week 4 by a sensitive PCR-based quantitative assay
HCV RNA undetectable at weeks 4 and 12
≥ 2 log reduction in HCV RNA level compared to baseline HCV RNA level (partial EVR) or HCV RNA negative at treatment week 12 (complete EVR)
HCV RNA negative by a sensitive test at the end of 24 or 48 weeks of treatment
HCV RNA negative 24 weeks aſter cessation of treatment
Reappearance of HCV RNA in serum while still on therapy
HCV RNA undetectable during Rx but positive aſterward
Failure to clear HCV RNA from serum aſter 24 weeks of therapy
Failure to decrease HCV RNA by > 2 logs at 12th week
> 2 log decrease in HCV RNA at 12th week of Rx but still HCV RNA positive at week 24
Best predictor of a long- term response to treatment
Predicts lack of SVR Clinical Utility
May allow shortening of course for genotypes 2 and 3 and possibly genotype 1 with low viral load
