Question: All of the following are considered negative predictors of a sustained virologic response (SVR) in a hepatitis C infection except?
C. insulin resistence
E. chronic renal insufficiency
Answer: SVR in the treatment of hepatitis C is defined as a non-detectable HCV RNA (viral load) measured six months after an end of treatment response (ETR) and discontinuation of antiviral treatment. When SVR occurs, a patient is cured of the virus 99% of the time; there is a <2% relapse rate three years following SVR. Bear in mind that the patient is not immune to reacquiring HCV if exposed again in the future. All of the above are negative risk factors for SVR rate except for age. African Amerian race, genotype 1 and 4, insulin resistance and CRI will all decrease likelihood of SVR and should be taken into account when making treatment decisions.