Impact of adherence to peginterferon-ribavirin combination therapy in chronic hepatitis C patients on achieving a sustained virologic response

Jeong, Soung Won; Kim, Jin-Dong; Woo, Hyun Young; You, Chan Ran; Lee, Sung Won; Song, Myeong Jun; Jang, Jung Won; Bae, Si Hyun; Choi, Jong Young; Yoon, Seung Kew

doi:10.3350/kjhep.2009.15.3.338

Cited by 11 publications

(6 citation statements)

References 20 publications

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“…Indeed, in our analysis, rapid normalization of ALT 4 weeks after treatment was a cost effective and useful tool that predicted obtaining of SVR as soon as possible. These results supported previous reports showing that absence of ALT level elevation during treatment was associated with SVR,14 whereas failure to return to normal ALT level was a strong predictor of combination treatment failure 15. Thus, SVR rate was significantly associated with ALT normalization during combination treatment in patients with initial abnormal ALT levels; in particular, rapid normalization of ALT during treatment in genotype 1 group might be considered as useful response factor in clinical practice, for patients with initial abnormal ALT levels.…”

Section: Discussionsupporting

confidence: 93%

Rapid normalization of alanine aminotransferase predicts viral response during combined peginterferon and ribavirin treatment in chronic hepatitis C patients

et al. 2012

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Background/AimsThe treatment for chronic hepatitis C (CHC) is removal of the virus in order to prevent progression to liver cirrhosis and hepatocellular carcinoma (HCC). Few data have been presented regarding the clinical significance of changes in the alanine aminotransferase (ALT) level in this context. We analyzed the patterns of changes in ALT level and investigated the relationship between the rapid normalization of ALT and sustained virologic response (SVR) after combined treatment with peginterferon and ribavirin.MethodsCHC patients (n=370) were classified into four groups according to the initial ALT level and subsequent changes: (1) initially abnormal ALT level and sustained abnormal ALT level during treatment, (2) initially abnormal ALT level but achievement of ALT normalization, (3) initially normal ALT level and variable ALT abnormality during treatment, and (4) initially normal ALT level and sustained normalization of ALT level during treatment. We subdivided groups 1 and 2 into those with patterns of decreased and normalization of ALT, with or without rapid normalization. We checked the end-treatment response (ETR) and SVR rates in each group and the factors associated with SVR, including patterns of changes in ALT level.ResultsA total of 168 patients completed the therapy (age=54.34±10.64 years [mean±SD], 95 males [56.5%], genotype 1:82 [48.8%]). SVR was achieved in 115 (68.45%) of the completely treated patients. The SVR rate was significantly lower in group 1 than in group 2 (37.8 vs. 81.6%, P<0.001), and significantly higher in the rapid normalization group than in the group without rapid normalization (78.5% vs. 41.2%, P<0.001). Multiple logistic regression analysis revealed that age (odds ratio [OR]=0.94, 95% confidence interval [CI]=0.91-0.98, P=0.005), viral genotype (OR=2.76, 95% CI=1.20-6.38, P=0.017), and initial hepatitis C virus RNA titer (OR=0.28, 95% CI=0.10-0.75, P=0.012) were identified as independent significant predictive factors for SVR.ConclusionsThe SVR rate is significantly associated with normalization, and especially rapid normalization of ALT. Rapid normalization of ALT by 4 weeks after treatment might be a useful response factor that is readily available in clinical practice, and especially for genotype 1 patients.

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Section: Discussionsupporting

confidence: 93%

Rapid normalization of alanine aminotransferase predicts viral response during combined peginterferon and ribavirin treatment in chronic hepatitis C patients

et al. 2012

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“…A previous study showed that Asian race is one of the independent predictors of sustained virological response in a multivariate logistic regression analysis [37]. The sustained virological response rates of Korean patients in particular are about 10% higher than those of Caucasian [38,39,40]. The causes of racial variation are still unclear.…”

Section: Discussionmentioning

confidence: 99%

Polymorphisms near <b><i>Interleukin 28B</i></b> Gene Are Not Associated with Hepatitis B Virus Clearance, Hepatitis B e Antigen Clearance and Hepatocellular Carcinoma Occurrence

et al. 2013

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Background: Polymorphisms near the IL28B gene have been proposed to be strongly associated with treatment response and the rate of spontaneous clearance of hepatitis C virus infection, and treatment response of hepatitis B virus (HBV) infection. In this study, we aimed to determine whether these polymorphisms could affect natural courses of HBV infection. Methods: Genetic variations were identified through direct DNA sequencing using TaqMan assay in 1,439 patients with past or present HBV infection. Subjects included 404 spontaneously recovered patients, 313 chronic hepatitis B (CHB) patients, 305 liver cirrhosis (LC) patients and 417 hepatocellular carcinoma (HCC) patients. Three polymorphisms near the IL28B gene, rs8099917T>G, rs12979860C>T and rs12980275A>G, were identified. Associations between these polymorphisms and HBV clearance, hepatitis B e antigen (HBeAg) clearance as well as HCC occurrence among patients were analyzed using logistic regression analyses adjusted for age and gender. Results: There were no significant associations between these polymorphisms and the HBV clearance both in CHB and LC groups. Similarly, these polymorphisms showed no significant associations with HBeAg clearance and the occurrence of HCC either. Discussion: No significant association was identified between polymorphisms near the IL28B gene and the natural courses of chronic HBV infection, including the HBV clearance and HCC occurrence.

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“…In another study from Japan, the upper limits of normal ALT were 29 IU/L in men and 23 IU/L in women when considering lifestyle factors . Regarding HCV patients, and previously where the interferon was the mainstay therapy, rapid normalization of ALT was used together with rapid virological response (RVR), as predictors for treatment outcomes, current practice guidelines for managing HCV, do not consider liver enzymes as a prerequisite for treatment, but still use them as markers of hepatic cell injury . We aim at studying changes in ALT levels during and after treatment of chronic HCV patients using DAAs in a group of patients with baseline enzymes falling below the current upper limit of normal according to currently used cutoff values, and try to explore whether a new upper limit of normal for ALT is to be considered in HCV patients based on the decline in ALT values in those patients as a response to successful treatment.…”

Section: Introductionmentioning

confidence: 99%

After successful hepatitis C virus antiviral therapy: It looks that normal alanine aminotransferase level is not the normal

Kassas

Alboraie

Mostafa

et al. 2017

Clinical Laboratory Analysis

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Impact of adherence to peginterferon-ribavirin combination therapy in chronic hepatitis C patients on achieving a sustained virologic response

Abstract: Adherence to therapy is a key factor in achieving an SVR. Supportive strategies to improve adherence will increase overall SVR rates.

Cited by 11 publications

References 20 publications

Rapid normalization of alanine aminotransferase predicts viral response during combined peginterferon and ribavirin treatment in chronic hepatitis C patients

Rapid normalization of alanine aminotransferase predicts viral response during combined peginterferon and ribavirin treatment in chronic hepatitis C patients

Polymorphisms near <b><i>Interleukin 28B</i></b> Gene Are Not Associated with Hepatitis B Virus Clearance, Hepatitis B e Antigen Clearance and Hepatocellular Carcinoma Occurrence

After successful hepatitis C virus antiviral therapy: It looks that normal alanine aminotransferase level is not the normal

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