An a priori prediction model of response to peginterferon plus ribavirin dual therapy in naïve patients with genotype 1 chronic hepatitis C

Abstract

Peg-interferon and ribavirin treatment Predictors of sustained virological response, Rapid virological response a b s t r a c t Background: Aim was to select naïve patients with genotype 1 chronic hepatitis C having a high probability of response to Peg-interferon + ribavirin therapy. Methods: In 1073 patients (derivation cohort), predictors of rapid and sustained virological response were identified by logistic analysis; regression coefficients were used to generate prediction models for sustained virological response. Probabilities at baseline and treatment week 4 were utilized to develop a decision rule to select patients with high likelihood of response. The model was then validated in 423 patients (validation cohort). Results: In the derivation cohort, 257 achieved rapid virological response and 818 did not, with sustained virological response rates of 80.2% and 25.4%, respectively; interleukin-28B polymorphisms, fibrosis staging, gamma-glutamyl transferase, and viral load predicted sustained virological response. Assuming a <30% sustained virological response probability for not recommending Peg-interferon + ribavirin, 100 patients (25.6%) in the validation cohort were predicted a priori to fail this regimen. Assuming a ≥80% sustained virological response probability as a threshold to continue with Peg-interferon + ribavirin, 61 patients were predicted to obtain sustained virological response, and 55 of them (90.2%) eventually did. Conclusions: This model uses easily determined variables for a personalized estimate of the probability of sustained virological response with Peg-interferon + ribavirin, allowing to identify patients who may benefit from conventional therapy.

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

“…These patients with high baseline HCV-RNA and advanced fibrosis are in urgent need for new therapeutic approaches and should be prioritized when sofosbuvir or other antivirals become available. A similar approach was recently proposed to identify a sub-group of patients infected with HCV genotype 1 who might benefit from peginterferon plus RBV therapy [32] . Owing to its retrospective nature, our study has several limitations.…”

Hepatitis C virus pharmacogenomics in Latin American populations: implications in the era of direct-acting antivirals

“…In this regard, several scientific societies and studies have declared that, until global access to DAAs is guaranteed, treatment-naïve patients exhibiting favorable clinical, genetic, and virologic profiles could still benefit with the PEG-IFN/RBV regimen; thus restricting the use of newer and expensive treatment schemes for “difficult to treat” patients 22,29,41,70,84–87…”

Impact ofIFNL4rs12979860 and rs8099917 polymorphisms on response to Peg-Interferon-α and Ribavirin in patients with congenital bleeding disorder and chronic hepatitis C

“…20,21 27 This study determined that SVR was strongly associated with RVR (OR=21) and cEVR (OR=11) in patients with HCV genotype-1 infection, which confirms the same observation determined previously among non-hemophilic HCV-infected individuals and indicates the importance of a rapid drop in HCV RNA level on HCV eradication. 28 Andriulli et al 29 found that achieving RVR was the main on-treatment predictor for achieving SVR. The current study demonstrated that attaining RVR played more of a key role in attaining SVR than either of the polymorphisms of the IFNL4 gene.…”