6533b856fe1ef96bd12b3293
RESEARCH PRODUCT
Identification of Naïve Hcv-1 Patients with Chronic Hepatitis who may Benefit from Dual Therapy with Peg-Interferon and Ribavirin.
Raffaele CozzolongoGiuseppe MazzellaPietro GattiTeresa SantantonioMartina FelderVincenza CalvarusoMassimo FasanoMaria Lorena AbateMaria Rosa ValvanoAntonio M. IppolitoAngelo AndriulliGiuseppina BrancaccioMichele MilellaAntonio CraxìFilomena MoriscoMichele BaronePaolo TundoMaurizio MargaglioneDomenica GioffredaMario AngelicoAntonina SmedileNicola AndriulliGiovanna D'andreaGiovanni Battista GaetaDi Marco VitoGiovanna Fattovichsubject
MaleIL28BChronic HCV liver diseaseHepacivirusGastroenterologyPolyethylene GlycolsVirological responseresponse predictorschemistry.chemical_compoundantiviral therapyGenotypeViralChronicchronic hepatitis C; antiviral therapy; response predictorsSettore MED/12 - Gastroenterologiavirus diseasesMiddle AgedHepatitis CRecombinant ProteinsCombinationHCVFemalePredictors of response; Ribavirin; Peg-interferon; HCV; Chronic HCV liver diseaseAdultmedicine.medical_specialtyGenotypeChronic HCV liver disease; HCV; Peg-interferon; Predictors of response; Ribavirin; Adult; Aged; Antiviral Agents; Drug Therapy Combination; Female; Genotype; Hepacivirus; Hepatitis C Chronic; Humans; Interferon-alpha; Male; Middle Aged; Polyethylene Glycols; RNA Viral; Recombinant Proteins; Ribavirin; HepatologyPredictors of responseViremiaAntiviral AgentsDrug TherapyChronic hepatitisInternal medicineRibavirinmedicinechronic hepatitis CHumansDual therapyRapid Virologic ResponseAgedgenotype 1Peg-interferonHepatologybusiness.industryRibavirinInterferon-alphamedicine.diseasedigestive system diseasesSurgeryPeg interferonPegIFNchemistryRNAbusinessdescription
Background & Aims The pool of HCV genotype 1 patients likely to be cured by peg-interferon and ribavirin remains to be quantified. Methods In 1045 patients treated with peg-interferon and ribavirin, two therapeutic strategies were confronted: the first one evaluated only baseline variables associated with sustained virological response (SVR), and the second one included the rapid virologic response (RVR) in addition to baseline predictors. An 80% SVR rate was the threshold to retain a strategy as clinically relevant. Results Overall, 414 patients (39.6%) attained SVR. In the first strategy, the hierarchy of features independently associated with SVR was IL28B CC genotype (OR 5.082; CI 3.637-7.101), low (80% SVR threshold. Only 26.6% of no-RVR patients attained SVR. Among the 255 RVR patients, the likelihood of SVR was 61.8% in those with unfavorable predictors, 80% in the presence of a single predictor, and 100% when both predictors were present. By using this model, 200 patients (19.1%) were predicted to have an 80% chance of being cured with dual therapy. Conclusions A consistent subset of naïve HCV-1 patients, identified by some baseline characteristics and RVR, may benefit from dual treatment with peg-interferon and ribavirin. © 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2014-01-01 |