6533b86cfe1ef96bd12c8d00
RESEARCH PRODUCT
Who is more likely to respond to dual treatment with pegylated-interferon and ribavirin for chronic hepatitis C? A gender-oriented analysis.
Vito Di MarcoL CovoloVincenza CalvarusoM LevreroM PuotiF SuterGb GaetaI C FerrarG RaimondoG FattovichT SantantonioA AlbertiR BrunoC MussiniM MondelliF DonatoAntonio CraxìMulticenter Italian Group For The Study Of Hepatitis C.subject
MaleHCV-RNA levelsHepacivirusHepacivirusLogistic regressionGastroenterologyCohort Studieschemistry.chemical_compoundPegylated interferonGenotypeantiviral therapygenderProspective Studiespeg-interferon and ribavirinProspective cohort studybiologysustained virologic responsevirus diseaseschronic hepatitis C; gender; HCV-RNA levels; IL28B polymorphisms; peg-interferon and ribavirin; sustained virologic responseMiddle AgedViral LoadTreatment OutcomeInfectious DiseasesDrug Therapy CombinationFemaleViral loadHCV-RNA levels; IL28B polymorphisms; chronic hepatitis C; gender; peg-interferon and ribavirin; sustained virologic response; Adult; Aged; Cohort Studies; Drug Therapy Combination; Female; Hepacivirus; Hepatitis C Chronic; Humans; Interferons; Male; Middle Aged; Prospective Studies; Ribavirin; Sex Factors; Treatment Outcome; Viral Loadmedicine.drugAdultmedicine.medical_specialtySex FactorsVirologyInternal medicineRibavirinmedicineHumanschronic hepatitis CRapid Virologic ResponseAgedHepatologybusiness.industryRibavirinHepatitis C Chronicbiology.organism_classificationdigestive system diseaseschemistryImmunologyInterferonsIL28B polymorphismsbusinessdescription
Summary We assessed, in real-life practice, viral, demographic, genetic and metabolic factors influencing the sustained virologic response (SVR), with a gender-oriented analysis, in patients with chronic hepatitis C virus (HCV) treated with pegylated interferon and ribavirin. Six hundred and seventy naive patients were treated with dual therapy and evaluated by gender and HCV genotype. Associations between baseline variables and SVR were assessed by multivariate logistic regression analysis. Among 362 genotype 1 patients, SVR was achieved in 158 patients (44%), and SVR was independently associated with age less than 50 years (OR 2.12; 95% CI 1.09–4.30; P = 0.039) and C/C genotype rs12979860 SNP (OR 2.83; 1.19–6.74; P = 0.002) in 163 females, while absence of visceral obesity (OR 2.491; 1.131–5.487; P = 0.023), HCV-RNA lower than 400 000 IU/mL (OR 2.66; 1.273–5.558; P = 0.009) and C/C genotype rs12979860 SNP (OR 4.969; 2.401–10.283; P < 0.001) were independently associated with SVR in 199 males. Combining favourable baseline variables, the probability of obtaining SVR ranged from 27.6% to 84.2% in females, and from 14.3% to 85.7% in males. The rate of SVR was 81.1% in 175 genotype 2 patients, and 69% in 100 genotype 3 patients. Rapid virologic response was the only valid predictor of SVR regardless of other features. In conclusions, in the setting of HCV genotype 1, chronic hepatitis, combining rapid virologic response and predictive factors, which are different for females and males, allows clinicians to single out a group of patients whose likelihood of SVR exceeds 80%. For these patients, triple therapy with first-generation protease inhibitors may be unwarranted.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2013-01-01 |