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Longitudinal assessment of HCV core antigen kinetics to monitor therapeutic response in the age of DAAs

BACKGROUND: In the economy of therapeutic monitoring, an affordable viral marker is essential in the era of direct-acting antivirals (DAAs). We elucidated the kinetics of HCVcAg to delineate its precise role in monitoring therapeutic response. METHODS: In this longitudinal study, 3208 patients were...

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Autores principales: Ponnuvel, Suresh, Prakash, Arul, Steve, Runal John, Doss, George Priya, Goel, Ashish, Zachariah, Uday George, Eapen, Chundamannil Eapen, Rebekah, Grace, Kannangai, Rajesh, Fletcher, Gnanadurai John, Abraham, Priya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9937470/
https://www.ncbi.nlm.nih.gov/pubmed/36800372
http://dx.doi.org/10.1371/journal.pone.0282013
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author Ponnuvel, Suresh
Prakash, Arul
Steve, Runal John
Doss, George Priya
Goel, Ashish
Zachariah, Uday George
Eapen, Chundamannil Eapen
Rebekah, Grace
Kannangai, Rajesh
Fletcher, Gnanadurai John
Abraham, Priya
author_facet Ponnuvel, Suresh
Prakash, Arul
Steve, Runal John
Doss, George Priya
Goel, Ashish
Zachariah, Uday George
Eapen, Chundamannil Eapen
Rebekah, Grace
Kannangai, Rajesh
Fletcher, Gnanadurai John
Abraham, Priya
author_sort Ponnuvel, Suresh
collection PubMed
description BACKGROUND: In the economy of therapeutic monitoring, an affordable viral marker is essential in the era of direct-acting antivirals (DAAs). We elucidated the kinetics of HCVcAg to delineate its precise role in monitoring therapeutic response. METHODS: In this longitudinal study, 3208 patients were tested for HCV RNA. A total of 423 patients were started on DAAs. Treatment response and kinetics of HCVcAg/RNA were assessed in treatment-naïve (n = 383) and previously treated (n = 40) patients with follow-up for 2 years. RESULTS: After the initiation of DAAs, the rate of relapse was significantly higher in the previously treated group than naive group [12.5% (5/40) Vs 2% (7/383), p<0.0001]. The response rate at RVR was significantly higher with HCVcAg than RNA in both groups (p<0.02). The kinetics of HCVcAg and RNA were significantly different at ETR and SVR12 in the naïve (p<0.04), but similar at all therapeutic points in the previously treated group. The correlation between HCVcAg and RNA was good at baseline, ETR and SVR, except RVR in both groups (r>0.6; p<0.0001). Furthermore, HCV genotypes, treatment regimen, CTP (<7/≥7) and MELD (<15/≥15) did not influence the therapeutic response and the viral replication kinetics (p>0.05). CONCLUSIONS: It is the first longitudinal study from India shows that the response rate and kinetics of HCVcAg are comparable to HCV RNA for an extended duration, except at RVR, irrespective of the HCV genotypes, treatment regimen, and liver disease severity. Hence, HCVcAg can be considered as a pragmatic marker to monitor therapeutic response and predict relapse in the era of DAAs.
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spelling pubmed-99374702023-02-18 Longitudinal assessment of HCV core antigen kinetics to monitor therapeutic response in the age of DAAs Ponnuvel, Suresh Prakash, Arul Steve, Runal John Doss, George Priya Goel, Ashish Zachariah, Uday George Eapen, Chundamannil Eapen Rebekah, Grace Kannangai, Rajesh Fletcher, Gnanadurai John Abraham, Priya PLoS One Research Article BACKGROUND: In the economy of therapeutic monitoring, an affordable viral marker is essential in the era of direct-acting antivirals (DAAs). We elucidated the kinetics of HCVcAg to delineate its precise role in monitoring therapeutic response. METHODS: In this longitudinal study, 3208 patients were tested for HCV RNA. A total of 423 patients were started on DAAs. Treatment response and kinetics of HCVcAg/RNA were assessed in treatment-naïve (n = 383) and previously treated (n = 40) patients with follow-up for 2 years. RESULTS: After the initiation of DAAs, the rate of relapse was significantly higher in the previously treated group than naive group [12.5% (5/40) Vs 2% (7/383), p<0.0001]. The response rate at RVR was significantly higher with HCVcAg than RNA in both groups (p<0.02). The kinetics of HCVcAg and RNA were significantly different at ETR and SVR12 in the naïve (p<0.04), but similar at all therapeutic points in the previously treated group. The correlation between HCVcAg and RNA was good at baseline, ETR and SVR, except RVR in both groups (r>0.6; p<0.0001). Furthermore, HCV genotypes, treatment regimen, CTP (<7/≥7) and MELD (<15/≥15) did not influence the therapeutic response and the viral replication kinetics (p>0.05). CONCLUSIONS: It is the first longitudinal study from India shows that the response rate and kinetics of HCVcAg are comparable to HCV RNA for an extended duration, except at RVR, irrespective of the HCV genotypes, treatment regimen, and liver disease severity. Hence, HCVcAg can be considered as a pragmatic marker to monitor therapeutic response and predict relapse in the era of DAAs. Public Library of Science 2023-02-17 /pmc/articles/PMC9937470/ /pubmed/36800372 http://dx.doi.org/10.1371/journal.pone.0282013 Text en © 2023 Ponnuvel et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Ponnuvel, Suresh
Prakash, Arul
Steve, Runal John
Doss, George Priya
Goel, Ashish
Zachariah, Uday George
Eapen, Chundamannil Eapen
Rebekah, Grace
Kannangai, Rajesh
Fletcher, Gnanadurai John
Abraham, Priya
Longitudinal assessment of HCV core antigen kinetics to monitor therapeutic response in the age of DAAs
title Longitudinal assessment of HCV core antigen kinetics to monitor therapeutic response in the age of DAAs
title_full Longitudinal assessment of HCV core antigen kinetics to monitor therapeutic response in the age of DAAs
title_fullStr Longitudinal assessment of HCV core antigen kinetics to monitor therapeutic response in the age of DAAs
title_full_unstemmed Longitudinal assessment of HCV core antigen kinetics to monitor therapeutic response in the age of DAAs
title_short Longitudinal assessment of HCV core antigen kinetics to monitor therapeutic response in the age of DAAs
title_sort longitudinal assessment of hcv core antigen kinetics to monitor therapeutic response in the age of daas
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9937470/
https://www.ncbi.nlm.nih.gov/pubmed/36800372
http://dx.doi.org/10.1371/journal.pone.0282013
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