IngentaConnect Effect of HCV viral dynamics on treatment design: lessons learned...

Author: Bain, V.G.¹

Source: The American Journal of Gastroenterology, Volume 96, Number 10, 1 October 2001 , pp. 2818-2828(11)

Abstract:

Viral load measurements provide an indication of viral replication, and thereby serve as a valuable tool to guide the initiation of therapy and subsequent changes. Plasma human immunodeficiency viral load strongly predicts the rate of decrease in CD4+ lymphocyte count, and progression to AIDS and death. Furthermore, the efficacy of antiretroviral therapy can be assessed by monitoring changes in plasma human immunodeficiency viral load. Similarly, viral load provides valuable information about the natural history of the hepatitis C virus infection. Hepatitis C viral load can be used to predict the likelihood of response to standard interferon-α treatment and other interferon-α regimens and to monitor treatment efficacy. Increased understanding of the natural history of the hepatitis C virus infection and the nature of resistance to interferon-α therapy suggests that effective treatment regimens must maintain serum levels of interferon-α. Ideally, interferon-α serum levels should provide constant pressure on the virus and should prevent viral rebound, thereby avoiding continued viral replication and minimizing the potential for emergence of resistant quasispecies. Current regimens designed to address these points include early aggressive intervention, combination drug regimens, prolonged maintenance, and novel interferons. By enabling the design and rapid assessment of new treatment regimens, viral load measurement will revolutionize the clinical management of the hepatitis C virus infection, as it has the HIV.

Document Type: Review article

DOI: 10.1016/S0002-9270(01)02796-4

Affiliations: 1: aDivision of Gastroenterology, Department of Medicine, University of Alberta, , Edmonton, Alberta, Canada

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Effect of HCV viral dynamics on treatment design: lessons learned from HIV