Quantitative HCV RNA monitoring during direct-acting antiviral (DAA) therapy: pretreatmen...
Детермінований перегляд YAML-сутності з джерельної бази. Клінічний авторитет лишається за вказаними source ID та статусом клінічного sign-off.
| ID | BMA-HCV-RNA-MONITORING-DAA-RESPONSE |
|---|---|
| Тип | Клінічна застосовність |
| Статус | переглянуто 2026-05-18 | потрібне рев’ю клінічної застосовності |
| Хвороби | DIS-HCV-MZL |
| Джерела | SRC-AASLD-IDSA-HCV-2023 SRC-EASL-HCV-2023 |
Дані про клінічну застосовність
| Біомаркер | BIO-HCV-RNA-QUANTITATIVE-MONITORING |
|---|---|
| Варіант | Quantitative HCV RNA — viral-load monitoring during DAA therapy |
| Хвороба | DIS-HCV-MZL |
| Рівень ESCAT | IIIA |
| Рекомендовані комбінації | SVR12-confirmed (cure): no further DAA; surveillance per IND-HCV-MZL-POST-DAA-SURVEILLANCE, Treatment failure / relapse: sofosbuvir + velpatasvir + voxilaprevir (POLARIS-1) salvage |
| Підсумок доказів | 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. |
Нотатки
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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