Sustained and rapid virological responses in hepatitis C clinical trials

Author(s): Akihito Tsubota, Tomomi Furihata, Yoshihiro Matsumoto, Kan Chiba

Direct-acting antivirals (DAAs) in combination with pegylated IFN-a and ribavirin drastically improve the rates of rapid virological response (RVR) and sustained virological response (SVR) in the treatment of chronic hepatitis C virus infection, specifically in difficult-to-cure hepatitis C virus genotype 1. At present, RVR is an important milestone highly predictive of SVR. Response-guided therapy based on RVR is important to shorten the treatment duration whilst preserving the greatly improved SVR rate, given that DAA-based treatments are costly and could produce serious adverse events and antiviral-resistant variants. Because strong factors other than RVR independently influence SVR, more highly personalized treatments should be developed through a combination of several robust factors. The advent of more potent DAAs may change the concept of RVR and SVR.