Gender influence on treatment of chronic hepatitis C genotype 1

Abstract

Introduction: Although various studies have been published regarding the treatment of chronic hepatitis C (CHC) with peginterferon (Peg-IFN) and ribavirin, little is known regarding the real impact of gender on the characteristics that influence the effectiveness and safety of antiviral treatment for CHC patients. The objective of this study was to evaluate the influence of gender on HCV treatment outcomes. Methods: A retrospective analytical study was conducted among selected carriers of CHC genotype 1, who were treated with Peg-IFN α-2b at a dose of 1.5 µg/kg or Peg-IFN α-2a at a dose of 180 µg/week plus a ribavirin dose of 1,000-1,250 mg/day, according to weight, between 2001 and 2007. Results: Among 181 patients undergoing treatment, the mean age was 46.4 ± 11.0 years and 46% were women. At baseline, 32% of the patients had advanced fibrosis (F3-F4 Scheuer), and 83% of the subjects had viral load > 400,000 IU/ml, without significant difference between the genders (p = 0.428 and p = 0.452, respectively). When compared with men, women had higher incidence of many adverse events such as anemia (p < 0.001) and higher need for dose reduction, for both Peg-IFN (p = 0.004) and ribavirin (p = 0.006). However, the rate of sustained virological response (SVR) did not differ between the genders: 45% (female) vs 41% (male); p=0.464. Conclusions: This study suggests that women and men react differently to combined therapy, especially in relation to the incidence of adverse events and the need for dose modification. Nevertheless, these differences do not influence the SVR rate.

Hepatitis C Worldwide and in Brazil: Silent Epidemic—Data on Disease including Incidence, Transmission, Prevention, and Treatment

“…The same SVR rate was shown in another study with patients who received only the conventional interferon and ribavirin [64]. A number of studies with hepatitis C genotype 1 patients treated with pegylated interferon in combination with ribavirin revealed SVR rates ranging from approximately 35 to 52% [65–68]. …”

A gender gap in primary and secondary heart dysfunctions in systemic sclerosis: a EUSTAR prospective study

“…Stratification or adjustment according to sex should allow identifying which therapeutic strategy has the greatest benefit for men and women, leading to the development of sex-tailored treatment regimens, as it has been recently demonstrated in depression and hepatitis C 46 47…”

Sex influences immune responses to viruses, and efficacy of prophylaxis and treatments for viral diseases

“…Sex differences in the efficacy and responses to antiviral treatment, including the standard combined treatment with pegylated interferon alpha and ribavirin, are only consistently observed between men and premenopausal women (Table 2). Among patients of reproductive ages, females experience more adverse reactions (e.g., anemia, weight loss, nausea, vision impairment, reduced thyroid function, and infections) to the combined antiviral drug treatment, are more likely to modify the doses of the antiviral drugs, and are more likely to interrupt or suspend treatment than males [82,83]. In HCV patients of reproductive ages who maintain at least 80% of the planned antiviral drug doses, the sustained virologic response is greater for females than males [84].…”