HCV Viral Load Testing Not Useful As Measure of New Hepatitis C Drug Effectiveness

Shyamasundaran Kottilil MBBS, PhD University of MarylandMedicalResearch.com Interview with:
Shyamasundaran Kottilil MBBS, PhD
Division of Infectious Diseases, Institute of Human Virology
University of Maryland, Baltimore
Laboratory of Immunoregulation
National Institute of Allergy and Infectious Diseases
National Institutes of Health, Bethesda, Maryland

Medical Research: What is the background for this study? What are the main findings?

Dr. Kottilil: During treatment with interferon-based therapies, hepatitis C viral load levels were clinically useful as on-therapy markers of treatment outcome. However, the standard-of-care for HCV treatment has recently evolved from interferon-based regimens to short-duration, all-oral, direct-acting antiviral (DAA) therapies. Therefore, it is important that we re-evaluate the utility of HCV viral loads during DAA regimens in guiding clinical decision-making.

We found that Hepatitis C viral loads on treatment and at end of treatment were not predictive of treatment success versus relapse with DAA therapy. Contrary to our experience with interferon-containing regimens, low levels of quantifiable HCV RNA at end of treatment did not preclude treatment success.

Medical Research: What should clinicians and patients take away from your report?

Dr. Kottilil: Clinicians and patients should be aware that frequent monitoring of Hepatitis C RNA levels during therapy may have little utility in guiding treatment duration. Additionally, detectable or low-level quantifiable viremia at end of treatment does not signify treatment failure or necessitate the extension of therapy. However, monitoring Hepatitis C viral levels on treatment for adherence on study medications is important.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Kottilil: One of the limitations of our study was our small and selective patient population. Therefore, we recommend further analysis of the predictive ability of Hepatitis C RNA levels for treatment outcome in larger DAA trials.

Citation:

Clin Infect Dis. 2015 Jun 15;60(12):1743-51. doi: 10.1093/cid/civ170. Epub 2015 Mar 2.

Utility of hepatitis C viral load monitoring on direct-acting antiviral therapy.

Sidharthan S1, Kohli A1, Sims Z1, Nelson A2, Osinusi A3, Masur H1, Kottilil S2.

MedicalResearch.com Interview with:, Shyamasundaran Kottilil MBBS, PhD Division of Infectious Diseases, Institute of Human Virology, University of Maryland, Baltimore, Laboratory of Immunoregulation, National Institute of Allergy and Infectious Diseases, & National Institutes of Health, Bethesda, Maryland (2015). HCV Viral Load Testing Not Useful As Measure of New Hepatitis C Drug Effectiveness MedicalResearch.com