Demographic profile, host, disease & viral predictive factors of response in patients with chronic hepatitis C virus infection at a tertiary care hospital in north India

Abstract

Background & objectives:Standard of care for chronic hepatitis C (CHC) in India is peginterferon and ribavirin (RBV). The response to treatment in real life stetting is unclear. The objectives of this study were to evaluate the demographic profile and assess the virological response and predictors of response in CHC patients.Methods:Consecutive patients with CHC were included in this study. Detailed clinical history, risk factors, and predictive factors of response were noted. Patients were treated with peginterferon α2b (1.5 µg/kg/wk) and RBV (12 mg/kg/day) for 6 to 18 months based on response.Results:A total of 211 patients were included in the analysis, mean age 40.6±12.3 yr, 144 (68%) were males and 71 (34%) had compensated cirrhosis. Commonest risk factor for acquiring CHC was previous transfusion and surgery (51%). Genotype 3 (72%) was most common followed by genotype 1 (23%). Overall sustained virologic response (SVR) was 64 per cent [95% CI 57.1%-70.4%]. The SVR was 66.5 per cent [95% CI 58.34-73.89%] for genotype 3 and 61.2 per cent [95% CI 46.23 to 74.80%] for genotype 1. Non-cirrhotics had better SVR rates compared to cirrhotics (76 vs 41%, P<0.001). On multivariate analysis, BMI ≥23 kg/m2, HOMA-IR ≥2, compliance (≤80%), and fibrosis >2 were predictors of low SVR.Interpretation & conclusions:Genotype 3 was the commonest HCV genotype. The commonest source of infection was previous transfusion and surgery. SVR rates for genotypes 3 were better than genotype 1 patients. Predictors of non-response were high BMI, insulin resistance, significant fibrosis and inadequate compliance.

Recipient Outcomes with Younger Donors Undergoing Living Donor Liver Transplantation

“…It has been associated with an increased rate of fibrosis and a higher incidence of HCC [24]. Furthermore, the response to direct acting anti-viral (DAA) medications is still not well understood, but genotype 3 has been associated with a lower response rate than other genotypes [25]. A relatively short follow-up and frequent use of DAAs might have a plausible role in the current study with very few mortalities attributable to HCV recurrence.…”

The influence of polymorphic GSTM1 gene on the increased susceptibility of non-viral hepatic cirrhosis: evidence from observational studies

“…Participants in Khan’s two enrolled studies are Indians. Patients in this region sometimes were reluctant to see the doctor because of economy stresses or lack of education, which interferes the early discovery and treatment of the cirrhosis [ 30 , 31 ]. This phenomenon can also be observed in the undeveloped area of China, the world’s first ranked incidence and mortality area of HC [ 32 ].…”

The role of biochemical variations and genotype testing in determining the virological response of patients infected with hepatitis C virus

“…Metabolic factors, such as high body mass index (BMI), presence and severity of liver steatosis, increasing homeostasis model assessment of insulin resistance score and older age, advanced stage of fibrosis and high viral load at baseline have been reported as negative predictors of response. [ 5 7 ] Of known pretreatment variables, a powerful predictor of response to treatment is the viral genotype. Genotypes 2 and 3 have got a better outcome than genotypes 1 and 4 with an SVR of 75%–85% versus 45%–55%, respectively.…”