Open AccessAssessment of baseline pretreatment factors and on‐treatment virological response to predict sustained virological response in patients with chronic hepatitis C treated with pegylated interferon and ribavirin
Author(s) -
Wen ShiChi,
Cheng LungChih,
Hsu JuiHung,
Lai HsinWen,
Shih PeiChen,
Tsai ChiChang,
Kuo WuHsien
Publication year - 2017
Publication title -
advances in digestive medicine
Language(s) - English
Resource type - Journals
ISSN - 2351-9800
DOI - 10.1002/aid2.12004
Subject(s) - ribavirin , medicine , pegylated interferon , gastroenterology , cirrhosis , viral load , combination therapy , chronic hepatitis , hepatitis c virus , immunology , virus
Summary Backgrounds Pegalated interferon (PEG‐IFN) combination with ribavirin (RBV) (PR) in accordance to response‐guide therapy (RGT) is a treatment option for chronic hepatitis C (CHC) in the past decade. Baseline host and viral factors and early viral kinetics are important determinants for patient using combination therapy. Aims We aimed to investigate the effects of host and viral factors on sustained virus response (SVR). We researched the possible predictors of an SVR. Methods We retrospectively analyzed a total of 158 CHC patients who had been treated with a PR dual therapy. Clinical parameters and virological responses were analyzed for their relationship with SVR. Results The overall SVR rate was 71.5% (113/158). Factors associated with an SVR were ALT levels > 3xULN, non‐AST/ALT > 1, non‐genotype 1 and non‐cirrhosis. Non‐genotype 1 (OR: 3.154; 95% CI: 1.309‐7.601; P = 0.010), and non‐cirrhosis (OR: 2.696; 95% CI: 1.045‐6.956; P = 0.004) were the predictors of an SVR. An SVR significantly increased in patients with an RVR and significantly reduced in patients with cEVR, pEVR, null response and relapse. In addition, an RVR was a powerful independent predictor of an SVR (OR: 38.263; 95% CI: 10.184‐143.757; P = 0.000). The positive predictive value (PPV) of an RVR on SVR was 92.2% (94/102). Conclusions Non‐cirrhosis, non‐genotype 1 and achievement of an RVR are independent predictors of SVR. A 4 week RVR is the best predictor of an SVR in CHC patients with a PR dual treatment. An RVR predicts treatment success early. Copyright © 2016, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.