A sustained virologic response to existing hepatitis C treatments — namely, pegylated interferon and ribavirin combined with a protease inhibitor — is less likely to benefit older patients with less advanced liver fibrosis, according to recent data. In light of these findings, older patients may opt to wait for future regimens with fewer adverse effects.
“The question of what value a [sustained virologic response], in itself, imparts on the patient is often left unstated,” researchers wrote in the Journal of Hepatology.” Given that many treatment candidates are without symptoms of their infection, patients must be well-informed regarding what, by way of prognosis improvement, [sustained virologic response] can offer. Yet, to date, this issue has received little attention despite being critical to informed consent.”
The researchers created the HCV Individualized Treatment-decision model to simulate the lifetime course of HCV-related liver disease according to two scenarios: the patient who achieves sustained virologic response (SVR) as a result of antiviral therapy and the patient who does not either because he or she does not accept therapy or fails to respond to treatment and the infection persists. The course of liver disease was compared for each model subject. The benefit of SVR was defined in the study as the likelihood of gaining additional life-years and “healthy” life-years spent avoiding liver failure.