Approximately 5%-10% of sustained responders will relapse with HCV infection over the next 5-10 years All HCV patients who achieve a sustained response to interferon monotherapy have been shown to have a "durable" response. Ninety-five percent of such patients continue to have undetectable virus when followed for 3-5 years. Whether this finding holds true for patients receiving combination Interferon/ribavirin therapy has not previously been addressed but results one such study are available now.

A subset of 316 sustained responders have now been followed for more than 6 months to determine whether the response to treatment is durable. Ninety-seven percent of patients demonstrated a durable response (defined as the absence of detectable HCV RNA when followed a further 12 to 36 months after cessation of therapy). Thus, the late relapse rate was < 3% and the durability of the response appeared to be equivalent for combination interferon/ribavirin and interferon monotherapy.

These findings indicate that irrespective of treatment strategy, a sustained virologic response 6 months after cessation of treatment will most likely be maintained in the majority of patients. This study will continue with a total follow-up of 5 years. However, A subset of 316 sustained responders have now been followed for more than 6 months to determine whether the response to treatment is durable.

Ninety-seven percent of patients demonstrated a durable response (defined as the absence of detectable HCV RNA when followed a further 12 to 36 months after cessation of therapy). Thus, the late relapse rate was < 3% and the durability of the response appeared to be equivalent for combination interferon/ribavirin and interferon monotherapy. These findings indicate that irrespective of treatment strategy, a sustained virologic response 6 months after cessation of treatment will most likely be maintained in the majority of patients. This study will continue with a total follow-up of 5 years. However results of previous studies have shown that individuals with hepatitis C and advanced fibrosis or cirrhosis respond less well to antiviral therapy.

The viral genotype also has an effect on treatment outcome. 70%-80% of those infected with genotypes 2 and 3 will be sustained responders to therapy compared with only 10%-20% of patients with genotype 1. He also noted that approximately 5%-10% of sustained responders will relapse with HCV infection over the next 5-10 years.

Dr Sharat C Misra MD, DM
Consultant Gastroenterologist & Hepatologist

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