Is P2/MS A New Pretreatment Predictor For eRVR and SVR in the Chronic Hepatitis C Patients Treated With Telaprevir Triple Therapy?: A Retrospective Observational Study

Abstract

AIM: Extended rapid virologic response (eRVR), defined as undetectable serum hepatitis C virus (HCV) RNA level at the 4th and the 12th weeks of the treatment, predicts sustained virologic response (SVR). Also eRVR provides to determine shortening response guided treatment duration. P2/MS<45, an effective and noninvasive marker reflecting the degree of hepatic fibrosis, demonstrates serious hepatic fibrosis.We studied the relationship between P2/MS and eRVR, that predicted SVR, among HCV genotype 1 (G1) infected and treated with triple therapy patients. P2/MS was evaluated whether it is a predictor for treatment response by foreseeing eRVR. Method: Twenty four patients infected with HCV-G1a and G1b and treated by triple therapy involving telaprevir, pegylated interferon-α and ribavirin, were enrolled in the study. P2/MS values were calculated before treatment. HCV-RNA levels were measured at the initiation period, the 4th and 12th weeks. Results: Eight patients of 24 had detectable HCV-RNA in the 4th week. Among 5 of these 8 patients had P2/MS<45. HCV-RNA was undetectable in 16 patients at the 4th week of the treatment. Twelve of them had P2/MS>45. Among 23 of 24 patients, HCV-RNA was undetectable at the 12th week of the treatment. We found that eRVR success was 86% in patients with P2/MS score>45 and 40% in patients with P2/MS<45. Conclusion: P2/MS is a noninvasive marker for detecting hepatic fibrosis in HCV patients. A positive correlation between P2/MS score and eRVR is demonstrated. We suggest that P2/MS should be used as a pretreatment predictive marker for HCV-G1 infected patients, estimating SVR and the patients suitable for shortening therapy.