Surveillance quantitative de l'ARN du VHC pendant le traitement antiviral à action directe (DAA): prétraitement...
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| ID | BMA-HCV-RNA-MONITORING-DAA-RESPONSE |
|---|---|
| Type | Pertinence thérapeutique |
| État | reviewed 2026-05-18 | actionability review required |
| Maladies | DIS-HCV-MZL |
| Sources | SRC-AASLD-IDSA-HCV-2023 SRC-EASL-HCV-2023 |
Faits relatifs à l ' action en justice
| Biomarqueur | BIO-HCV-RNA-QUANTITATIVE-MONITORING |
|---|---|
| Variante | ARN du VHC quantitatif — surveillance de la charge virale pendant le traitement par DAA |
| Maladie | DIS-HCV-MZL |
| Niveau ESCAT | IIIA |
| Combinaisons recommandées | SVR12-confirmed (cure): no further DAA; surveillance per IND-HCV-MZL-POST-DAA-SURVEILLANCE, Treatment failure / relapse: sofosbuvir + velpatasvir + voxilaprevir (POLARIS-1) salvage |
| Résumé des faits | Quantitative HCV RNA monitoring during direct-acting antiviral (DAA) therapy: pretreatment viral load (baseline), end-of-treatment (EOT), and Sustained Virological Response at 12 weeks (SVR12) are the standard treatment-response milestones (AASLD-IDSA 2023; EASL 2023). SVR12 is the evidence-based cure surrogate. Persistent viraemia after week 4 / EOT or detectable viraemia at SVR12 → relapse; switch to a salvage regimen containing sofosbuvir-velpatasvir-voxilaprevir (POLARIS-1). In HCV-associated MZL, lymphoma-response correlates with virologic response (Arcaini 2014; Hermine 2002); HCV eradication itself is first-line MZL therapy for indolent disease per ESMO MZL 2024. ESCAT IIIA — biomarker directs DAA regimen selection / continuation decisions and (in HCV-MZL) drives the primary cancer-directed therapy. |
Notes
STUB pending two-Co-Lead signoff. In the HCV-MZL anchor disease, viral eradication is the first-line cancer-directed intervention for indolent disease (ESMO MZL 2024). The Indication entities listed cover (a) the prevention-time DAA decision and (b) post-cure cancer surveillance. A future treatment-time IND-HCV-MZL-1L-ANTIVIRAL Indication is also linked (already present: ind_hcv_mzl_1l_antiviral.yaml). Note: SVR12 logic is the same across genotypes 1-6; this BMA is HCV-MZL-anchored because that is the directly relevant oncology disease for this KB. Hepatocellular surveillance after SVR is tracked separately under BMA-AFP-HCC-AASLD-SURVEILLANCE.
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