Rapid virological response tailors the duration of treatment in hepatitis C virus genotype 3 patients treated with pegylated interferon alfa-2a and ribavirin in Pakistan

Gill, Uzma; Aziz, Hafsa; Gill, Muzaffar Lateef

doi:10.1016/j.ijid.2013.05.012

Cited by 6 publications

(7 citation statements)

References 23 publications

(21 reference statements)

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“…The present study demonstrated a substantial difference in the sustained virological response rate between patients with no and significant liver fibrosis by univariate logistic analysis (79.5% vs. 48%, p = 0.003). The presence of significant liver fibrosis and cirrhosis has long been recognized to be associated with lower probability of treatment success in GT3 patients; our conclusions concerning mild liver fibrosis as a favorable factor are in agreement with those reported by many other investigators [5, 6, 15, 19, 23]. …”

Section: Discussionsupporting

confidence: 93%

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Predictors of sustained virological response in patients with hepatitis C virus genotype 3 infection

Zarębska-Michaluk

Lebensztejn

Chrapek

et al. 2016

ceh

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Aim of the studyTo assess predictors of sustained virological response (SVR) in patients with chronic hepatitis C virus (HCV) genotype 3 treated with standard therapy.Material and methodsWe retrospectively investigated data of 116 consecutive treatment-naïve patients chronically infected with HCV genotype 3, treated with pegylated interferon alpha (PegIFNα) and ribavirin (RBV) for 24 weeks. HCV RNA at week 4 (rapid virological response – RVR) and week 12 (early virological response – EVR) were measured in 85 and 105 patients respectively. Liver biopsy data were available for 103 patients. The variables were compared between patients with an SVR and those without.ResultsOverall 70.7% of patients achieved an SVR. Pretreatment factors including younger age, mild liver fibrosis as well as normal values of gamma-glutamyl transferase (GGT) and platelet count were significantly associated with higher SVR rate in univariate analysis. In the multivariate analysis only baseline platelet count > 140 000/µl and normal GGT activity were correlated with higher SVR rate. At weeks 4 and 12 HCV RNA was undetectable in 34.1% and 84.8% of patients respectively. The SVR rate was significantly higher in patients with an RVR compared to those without (p = 0.002). Only 2 patients with a rapid and early virological response did not achieve an SVR; both had negative pretreatment prognostic factors.ConclusionsIn treatment-naïve patients with genotype 3 HCV infection, low baseline platelet count and elevated GGT activity were significantly associated with poor response to PegIFNα and RBV. Achieving a rapid and early virological response was associated with higher likelihood of an SVR.

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Section: Discussionsupporting

confidence: 93%

“…Several studies have supported our findings that younger patients chronically infected with GT3 are more likely to achieve an SVR during therapy with interferon and RBV [6, 13, 14, 23–26]. …”

Section: Discussionsupporting

confidence: 87%

Predictors of sustained virological response in patients with hepatitis C virus genotype 3 infection

Zarębska-Michaluk

Lebensztejn

Chrapek

et al. 2016

ceh

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“… 14 This was higher than the response rate in a Canadian study (54%). 15 Host genetics, 15 geographic variations, 16 difference of body weight in race, 17 and pretreatment conditions among study groups may account for the difference in response status. Our findings indicated that RVR was not a significant predictor of SVR, suggesting SVR was achieved without RVR in many cases.…”

Section: Discussionmentioning

confidence: 99%

“…Comparable rate of SVR such as ≥80% in patients infected with GT3 were reported in other settings. 16 , 22 In a serological study on HCV-infected patients in Myanmar, 75% (18/24) were with GT3. 10 A concern was that there was a comparable SVR between GT1 (81.2%) and GT3 (85.5%).…”

Section: Discussionmentioning

confidence: 99%

Sustained Virologic Response to a Dual Peginterferon alfa-2a and Ribavirin in Treating Chronic hepatitis C Infection

et al. 2015

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“…Several studies have defined the pretreatment patient features, such as viral genotypes and subjects with favorable IL28B genotypes, markedly affect the likelihood of attaining a SVR ( 1 , 10 - 12 ). On-therapy kinetics of antiviral response also plays an important role; the rapid and early virological response are the most important factors ( 13 - 15 ). Moreover, although the relapse rate over time is one of the most important problems, which is clinicians’ concern, little is known about the effect of these values on relapse in the management of long-term follow-up.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Pegylated Interferon Alpha and Ribavirin Efficacy and Long-Term Assessment of Relapse in Patients With Chronic Hepatitis C: A One-Center Experience From China

Zhan

Chen

et al. 2015

Hepat Mon

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Background:Sustained virological response (SVR) and virological relapse maintain pivotal roles in the management of chronic hepatitis C (CHC); however, there is little data regarding the long-term outcomes of patients with CHC in China.Objectives:We aimed to investigate the predictive factors of therapeutic effect and viral relapse in patients who achieved end-of-treatment response (ETR).Patients and Methods:We retrospectively analyzed clinical, biochemical and virological data of 169 adult patients with CHC from China who were not treated with pegylated interferon-alpha (PEG IFN-α) and ribavirin, of which 142 achieved ETR and with a follow-up period ranging from six months to six years. Statistical analysis was performed by SPSS 20.0.Results:Of the 169 patients, 124 (73.4%) achieved SVR and 23 (16.2%) experienced relapses post-therapy in cases of ETR patients. We considered sex, age, alanine aminotransferase, aspartate transaminase, baseline hepatitis C virus RNA level, HCV genotypes, IL28B rs12979860 genotype, rapid virological response (RVR), and early virological response (EVR). For antiviral effect in patients with CHC, HCV genotypes (2, 3) (χ2 = 11.285, P = 0.001), IL28B genotype (rs12979860 CC) (χ2 = 16.552, P < 0.001), RVR (χ2 = 37.339, P < 0.001), and EVR (χ2 = 70.265, P < 0.001) were significantly correlated with achieving SVR. For ETR patients with long-term follow-up, the relapse rate within six months was significantly higher than within other periods during six-year follow-up (χ2 = 7.792, P = 0.005). Relapse was virtually not observed after therapy ceased for 48 weeks. The IL28B genotype (rs12979860 CT/TT) (OR = 0.102; 95% CI, 0.031-0.339; P < 0.001), lower RVR (OR = 0.239; 95% CI, 0.078-0.738; P = 0.013), and EVR (OR = 0.102; 95% CI, 0.016-0.661; P = 0.017) were independent risk factors for relapse.Conclusions:Our study comprehensively explored the predictive factors of therapeutic effect of administered drugs and analyzed viral relapse during a six-months to six-year follow-up period from China. The SVR may not be the perfect endpoint of HCV therapy in Chinese people; we recommend 48 weeks after treatment withdrawal as the suitable time point.

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Rapid virological response tailors the duration of treatment in hepatitis C virus genotype 3 patients treated with pegylated interferon alfa-2a and ribavirin in Pakistan

Abstract: RVR is useful to individualize the duration of treatment and to predict the treatment outcome. A short treatment of 16 weeks is as effective as 24 weeks in HCV genotype 3 patients who achieve RVR, who have a low BMI, and are younger in age.

Cited by 6 publications

References 23 publications

Predictors of sustained virological response in patients with hepatitis C virus genotype 3 infection

Predictors of sustained virological response in patients with hepatitis C virus genotype 3 infection

Sustained Virologic Response to a Dual Peginterferon alfa-2a and Ribavirin in Treating Chronic hepatitis C Infection

Predictors of Pegylated Interferon Alpha and Ribavirin Efficacy and Long-Term Assessment of Relapse in Patients With Chronic Hepatitis C: A One-Center Experience From China

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