Pre-treatment prediction of response to peginterferon plus ribavirin in chronic hepatitis C genotype 3

Abstract

AIM:To evaluate pre-treatment factors associated with sustained virological response (SVR) in patients with hepatitis C virus (HCV) genotype 3 treated with peginterferon and ribavirin (RBV). (62/107) of the patients achieved an SVR and 42% (45/107) did not. In the multivariate logistic regression analysis, pre-treatment HCV-RNA ≥ 600000 UI/mL (OR = 0.375, 95%CI: 0.153-0.919, P = 0.032) and advanced fibrosis (OR = 0.278, 95%CI: 0.113-0.684, P = 0.005) were significantly associated with low SVR rates. In patients with pre-treatment HCV-RNA ≥ 600000 UI/mL and advanced fibrosis, the probability of achieving an SVR was 29% (95%CI: 13.1-45.2). In patients with pre-treatment HCV-RNA < 600000 UI/mL and mild to moderate fibrosis, the probability of achieving an SVR was 81% (95%CI: 68.8-93.4). METHODS: CONCLUSION:In patients with HCV genotype 3 infections the presence of advance fibrosis and high pre-treatment viral load might be associated with poor response to peginterferon plus RBV. These patients could benefit the most from new direct antiviral agentsbased regimes.

The role of hepatic progenitor cells in predicting response to therapy in Egyptian patients with chronic hepatitis C, genotype 4

“…This is in line with Rizk et al10 who obtained SVR in 45.5% of Egyptian patients with HCV, genotype 4. Higher levels of SVR (58%) were reported in patients with genotype 39 and lower levels (36%) were observed in patients genotype 18 . These data support the conclusion of Jang and Chung32 that genotype 1 responds weakly to treatment, while genotype 3 responds better.…”

“…Viral load was evaluated as a predictive factor by some studies with controversial results8–10 . The stage of liver fibrosis was claimed to be a good predictor of treatment response in HCV infection9,11. However, this claim could not be supported by others8,10,12 Last but not least, was the genotyping of IL-28 B which has been reported to be a strong predictor of treatment outcome in HCV patients10,13–15.…”

“…Hepatic progenitor cells (HPCs) are small cells located in the periportal region of the liver16. Although the role of HPCs in liver fibrogenesis has been extensively studied9,10,17,18, their value in predicting sustained virological response of patients with HCV to treatment was not previously evaluated except in two reports. The first was Tsamandas et al17 on 77 patients with HCV of different genotypes.…”

Autoimmune manifestation of hepatitis C virus infection as a risk for late virological relapse after pegylated interferon and ribavirin therapy

“…Some studies showed that predisposition for the HCV relapse is related to female gender, older age, high body mass index (BMI), high viral load before treatment, HCV genotype 1, HCV molecular characteristics (especially HCV core region), genetic predisposition of patients (ILB28), previous therapy with IFN and also cumulative dose of administered drugs, ribavirin, as most important [16][17][18] . Despite the statistical irrelevance, due to a small number of patients in addition to CHC, all three patients had some autoimmune disease in common -the patient No.…”

Steatosis and hepatitis C

“…In patients with chronic HCV, the presence of steatosis can predict treatment failure (in the cases of pegylated interferon and ribavirin) [ 19 , 20 ]. Compared with other predictors of treatment failure in HCV, such as genotype, viral load and ethnicity, the relationship between steatosis and treatment failure is less well understood.…”