Treatment Response and Long-Term Outcome of Peginterferon α and Ribavirin Therapy in Korean Patients with Chronic Hepatitis C

Jung, Cheulhee; Um, Soon Ho; Kim, Tae Hyung; Yim, Sun Young; Suh, Sang Jun; Yim, Hyung Joon; Seo, Yeon Seok; Choi, Hyuk Soon; Chun, Hoon Jai

doi:10.5009/gnl15360

Cited by 4 publications

(8 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our cohort, there is a significantly higher SVR of 73.8% among patients with hepatitis C genotype 1 infection that is similar to Korea [ 9 ] and Taiwan [ 10 ]. This may be due to the IL28B CC polymorphism prevalent in our predominantly Chinese population [ 17 ].…”

Section: Discussionsupporting

confidence: 56%

“…It is known that IL28B genotypes can predict response to treatment with interferon and ribavirin to hepatitis C and that ITPA variant, which predicts the development of anaemia in patients on interferon [ 15 , 18 ], can have an impact on the total dose of ribavirin received during the course of treatment and thus impact the treatment outcome. Hence, it is reasonable to expect better SVR rates among patients with the favourable genotypes [ 9 , 10 , 32 ]. In the Western population, the SVR was 65% [ 4 ], even after adding a first generation DAA (Telapravir) to the PEG-IFN and ribavirin combination, while the same treatment combination yielded a SVR rate of 87.7% in an Asian population [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

“…Many times, use of these new drugs is either limited by individual patient’s ability to afford them in places where patients have to pay for their own medications or patients who already have significant complications from HCV infection even in countries with national healthcare schemes [ 7 , 8 ]. Data from Asia have shown favourable responses to pegylated interferon (PEG-IFN) and ribavirin in patients with hepatitis C and been attributed to favourable IL28B genotypes [ 9–11 ]. Hence, healthcare providers may still have to consider PEG-IFN in combination with ribavirin as a treatment option [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Real world experience with pegylated interferon and ribavirin in hepatitis C genotype 1 population with favourableIL28Bpolymorphism

Ekstrom

Kumar

Zhao

et al. 2016

Gastroenterol. Rep.

View full text Add to dashboard Cite

Background and aim: Conventional hepatitis C treatment using pegylated interferon (PEG-IFN) and ribavirin is associated with significant side effects. IL28B polymorphism can predict response to treatment, with CC genotype having a better response. ITPA gene deficiency protects against clinically significant anaemia induced by treatment. The purpose of this study was to determine IL28B polymorphism and ITPA variation among hepatitis C genotype 1 patients who have undergone therapy with PEG-IFN and ribavirin and their association with sustained viral response (SVR). Methods: All hepatitis C genotype 1 patients who had been treated with PEG-IFN and ribavirin over the past 10 years were identified by available medical records and were contacted by letter of invitation to participate in the study. Blood samples for IL28B and ITPA genotyping were obtained. Medical records were reviewed for verification of treatment response, development of anaemia and if treatment reduction was required during the treatment. Results: A total of 61 patients with hepatitis C genotype 1 were treated with PEG-IFN and ribavirin, of whom 42 agreed to participate in the study. Mean age was 45.6±12.9 years at time of treatment, and 83.3% of patients were males. Thirty-three (78.6%) had IL28B CC genotype, of whom 25 (75.8%) obtained SVR compared with only 3 of 9 (33.3%) non C/C genotype patients who achieved SVR (P=0.041). Eleven (26.1%) patients had ITPA AC genotype, and 30 (71.4%) had CC genotype. There was no statistically significant difference between ITPA AC and CC genotypes in predicting clinically significant anaemia (45.5% vs 63.3%, P=0.302). Even among patients who developed anaemia, 70.8% still managed to achieve SVR. Treatment reduction also had no impact on SVR. Conclusion: Hepatitis C genotype 1 patients should be informed of the response rate for treatment with PEG-IFN and ribavirin in a population with favourable IL28B genotype before consideration of newer therapeutic options.

show abstract

Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Real world experience with pegylated interferon and ribavirin in hepatitis C genotype 1 population with favourableIL28Bpolymorphism

Ekstrom

Kumar

Zhao

et al. 2016

Gastroenterol. Rep.

View full text Add to dashboard Cite

show abstract

“…Forty‐four studies [ 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 ] with a total 35,739 patients and 107,548 person‐years follow‐up were included (Tables 1 , 2 , 3 ). Thirty‐six studies (29,444 patients, 91,049 person‐years follow‐up) had required data for calculating HCC incidence among patients with cirrhosis (Table 2 ), with cirrhosis defined by histopathology ( n = 7) or a combination of histopathology, liver stiffness measurement, imaging, or clinical feat...…”

Section: Resultsmentioning

confidence: 99%

HCC incidence after hepatitis C cure among patients with advanced fibrosis or cirrhosis: A meta‐analysis

et al. 2022

View full text Add to dashboard Cite

Background and Aims HCV cure reduces but does not eliminate the risk of HCC. HCC surveillance is recommended in populations where the incidence exceeds 1.5% per year. In cirrhosis, HCC surveillance should continue after HCV cure, although it is uncertain if this should be indefinite. For patients with advanced fibrosis (F3), guidelines are inconsistent in their recommendations. We evaluated the incidence of HCC after HCV cure among patients with F3 fibrosis or cirrhosis. Approach and Results This systematic review and meta‐analysis identified 44 studies (107,548 person‐years of follow‐up) assessing the incidence of HCC after HCV cure among patients with F3 fibrosis or cirrhosis. The incidence of HCC was 2.1 per 100 person‐years (95% CI, 1.9–2.4) among patients with cirrhosis and 0.5 per 100 person‐years (95% CI, 0.3–0.7) among patients with F3 fibrosis. In a meta‐regression analysis among patients with cirrhosis, older age (adjusted rate ratio [aRR] per 10‐year increase in mean/median age, 1.32; 95% CI, 1.00–1.73) and prior decompensation (aRR per 10% increase in the proportion of patients with prior decompensation, 1.06; 95% CI, 1.01–1.12) were associated with an increased incidence of HCC. Longer follow‐up after HCV cure was associated with a decreased incidence of HCC (aRR per year increase in mean/median follow‐up, 0.87; 95% CI, 0.79–0.96). Conclusions Among patients with cirrhosis, the incidence of HCC decreases over time after HCV cure and is lowest in patients with younger age and compensated cirrhosis. The substantially lower incidence in F3 fibrosis is below the recommended threshold for cost‐effective screening. The results should encourage the development of validated predictive models that better identify at‐risk individuals, especially among patients with F3 fibrosis.

show abstract

“…Therefore, compared to patients with no or mild fibrosis (F0/1), treatment is strongly indicated in patients with fibrosis stage F2. [ 29 – 34 ] Thus, TE alone (with a relatively low sensitivity) may not be sufficient in clinical practice for the large-scale screening of liver fibrosis. Further studies are, however, necessary to analyze the diagnostic value of TE concomitant with the use of characteristic clinical features and other noninvasive diagnostic methods.…”

Section: Discussionmentioning

confidence: 99%

Feasibility and Efficacy of Transient Elastography using the XL probe to diagnose liver fibrosis and cirrhosis

et al. 2018

View full text Add to dashboard Cite

Background:Transient elastography (TE) has been validated as an effective noninvasive tool for the assessment of liver fibrosis. The XL probe is a new probe that was initially designed for use in patients with obesity. A meta-analysis was performed to assess the feasibility and efficacy of TE using the XL probe.Methods:In September 2016, we systematically searched the PubMed and Science Direct search engines. The feasibility of TE was evaluated based on the failure rate and the results of the unreliable liver stiffness measurement (LSM). The efficacy of TE was measured using sensitivity, specificity, and summary receiver-operating characteristic as measures/indices assessed in different stages of fibrosis. Heterogeneity was measured using the chi-squared test and the Q-statistic. We used the 95% confidence interval (95% CI) as an effect measure.Results:We included 8 studies in the meta-analysis. When the XL was compared to the M probe, the former showed a lower risk of failure rate [relative risk (RR) 0.24, 95% CI 0.14–0.38]. In patients with a body mass index ≥30 kg/m2, the XL probe showed a statistically significantly lower risk of failure rate (RR 0.16, 95% CI 0.08–0.32) but no significant improvement (RR 0.76, 95% CI 0.50–1.16) in the unreliable LSM result. In patients showing liver fibrosis stage ≥F2, the XL probe showed a sensitivity of 0.56 (95% CI 0.39–0.72), specificity of 0.71 (95% CI 0.61–0.79), and an area under the curve (AUC) of 0.71. The results observed in patients with liver fibrosis stage F4 were more promising with a sensitivity of 0.84 (95% CI 0.76–0.90), specificity of 0.78 (95% CI 0.70–0.84), and an AUC of 0.88.Conclusion:TE using the XL probe demonstrates significant diagnostic utility in patients with liver fibrosis and is likely to be more reliable than the M probe in patients with obesity. Large prospective multicenter studies are, however, necessary to establish the new cut-off values to be used for the XL probe in patients with obesity.

show abstract

Treatment Response and Long-Term Outcome of Peginterferon α and Ribavirin Therapy in Korean Patients with Chronic Hepatitis C

Cited by 4 publications

References 29 publications

Real world experience with pegylated interferon and ribavirin in hepatitis C genotype 1 population with favourableIL28Bpolymorphism

Real world experience with pegylated interferon and ribavirin in hepatitis C genotype 1 population with favourableIL28Bpolymorphism

HCC incidence after hepatitis C cure among patients with advanced fibrosis or cirrhosis: A meta‐analysis

Feasibility and Efficacy of Transient Elastography using the XL probe to diagnose liver fibrosis and cirrhosis

Contact Info

Product

Resources

About