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A European single centre experience of management of hepatitis C virus genotype 4 infection with pegylated‐interferon and ribavirin
Author(s) -
Selvapatt Nowlan,
Habibi Maximillian S.,
Brown Ashley
Publication year - 2015
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.24228
Subject(s) - ribavirin , medicine , pegylated interferon , hepatitis c virus , context (archaeology) , hepatitis c , viral load , univariate analysis , multivariate analysis , cohort , virology , gastroenterology , virus , biology , paleontology
New direct acting antiviral agents are revolutionising hepatitis C virus (HCV) treatment. However, to date limited clinical trial data exists for outcomes in genotype 4 (GT4) HCV patients. GT4 HCV is more common in Africa, the Middle East, and Asia, and limited data exists to date for outcomes in Europe. We report the first “real‐life” sustained virological response (SVR) outcomes using pegylated interferon and ribavirin for HCV GT4 in the UK, and the largest European single centre cohort. HCV GT4 patients treated at a London, UK centre between 2002 and 2014 were assessed for SVR outcomes. Patient age, sex, region of origin, co‐infection with HIV, pre‐treatment liver biopsy histological assessment, genotype subtyping, treatment duration, and dose reductions were compared against SVR outcomes on univariate analysis. Multivariate analysis was performed on results with P < 0.1. A total of 118 patients were treated with HCV GT4 during the study period, 57 achieved SVR (48%). On univariate analysis age ≥45 ( P < 0.0001), high viral load ( P < 0.0001), Ishak staging 5–6 ( P < 0.0001), and non‐Egyptian Africans ( P = 0.0059) were all negatively associated with SVR. Eastern Europeans appeared to have higher SVR ( P < 0.0001). Using multivariate correlation viral load ( P = 0.0005); Ishak staging ( P = 0.0031) and age ( P = 0.0003) were associated with SVR but not country of origin ( P = 0.0645). Outcomes with pegylated interferon and ribavirin for HCV GT4 in this “real‐life” setting were sub‐optimal especially in the context of newer regimens. Patients with older age, high viral loads, and advanced disease need prioritisation for alternative treatments. J. Med. Virol. 87:1716–1721, 2015 . © 2015 Wiley Periodicals, Inc.