Liver enzyme normalization predicts success of Hepatitis C oral direct-acting antiviral treatment

Clin Invest Med. 2017 Apr 26;40(2):E73-E80. doi: 10.25011/cim.v40i2.28198.

Abstract

Purpose: Monitoring of hepatitis C virus (HCV) treatment response is performed by serial HCV RNA measurements; however, this may not be useful for predicting treatment success or failure with oral direct-acting antiviral agent (DAA) therapies. Liver enzyme levels, which are elevated in chronic HCV and tend to decline on therapy, may serve as a more logistically and economically feasible alternative for monitoring treatment response.

Source: The Ottawa Hospital Viral Hepatitis Clinic patients (n=219), receiving interferon-free oral DAA treatments, were assessed for liver enzymes and HCV RNA levels at baseline, week 4 and ≥12 weeks post-treatment. Suppression cut points used for this analysis were ALT ≤ 40U L-1 and AST ≤ 30U L-1. The primary outcome was week 12 sustained virologic response (SVR). By our analysis, all indicators had strong PPV (>90%) but limited NPV (.

MeSH terms

  • Administration, Oral
  • Adult
  • Antiviral Agents / administration & dosage*
  • Antiviral Agents / therapeutic use*
  • Female
  • Hepacivirus / drug effects*
  • Hepacivirus / pathogenicity*
  • Hepatitis C / drug therapy*
  • Hepatitis C / enzymology*
  • Hepatitis C / pathology
  • Humans
  • Liver / enzymology
  • Liver / virology
  • Male
  • Middle Aged
  • RNA, Viral / genetics
  • Treatment Outcome

Substances

  • Antiviral Agents
  • RNA, Viral