Estimating the likelihood of sustained virological response in chronic hepatitis C therapy

Abstract

The likelihood of a sustained virological response (SVR) is the most important factor for physicians and patients in the decision to initiate and continue therapy for chronic hepatitis C (CHC) infection. This study identified predictive factors for SVR with peginterferon plus ribavirin (RBV) in patients with CHC treated under 'real-life' conditions. The study cohort consisted of patients from a large, retrospective German multicentre, observational study who had been treated with peginterferon alfa-2a plus RBV or peginterferon alfa-2b plus RBV between the years 2000 and 2007. To ensure comparability regarding peginterferon therapies, patients were analysed in pairs matched by several baseline variables. Univariate and multivariate logistic regression analyses were used to determine the effect of nonmatched baseline variables and treatment modality on SVR. Among 2378 patients (1189 matched pairs), SVR rates were 57.9% overall, 46.5% in HCV genotype 1/4-infected patients and 77.3% in genotype 2/3-infected patients. In multivariate logistic regression analysis, positive predictors of SVR were HCV genotype 2 infection, HCV genotype 3 infection, low baseline viral load and treatment with peginterferon alfa-2a. Negative predictors of SVR were higher age (≥40 years), elevated baseline gamma-glutamyl transpeptidase (GGT) and low baseline platelet count (<150,000/μL). Among patients treated with peginterferon plus RBV in routine clinical practice, genotype, baseline viral load, age, GGT level and platelet levels all predict the likelihood of treatment success. In patients matched by baseline characteristics, treatment with peginterferon alfa-2a may be a positive predictor of SVR when compared to peginterferon alfa-2b.

Importance of IL-10 and IL-6 during chronic hepatitis c genotype-1 treatment and their relation with IL28B

“…These results concur with those of previous large prospective studies of pegIFN-a/RBV therapy [17][18][19]. With regard to IL-6, as lower concentration of IL-6 at baseline in SVR was observed, IL-6 baseline level could serve as a predictive factor for SVR.…”

Predictors of treatment response in patients with hepatitis C 1b genotype

“…The rate of SVR in the current study was 50%, which is consistent with our previous data [30], as well as with the results obtained from clinical trials [12][13][14][15] and from "real life" clinical settings [31,32].…”

Pathology Predictors of Response to Combined Therapy of Chronic HCV Patients; Is it Applicable in the DAA Era?

“…Baseline viral load was lower in our SVR group and it was higher in the relapsers, that observation showed statistical significance [14,15].…”

“…On the contrary, El Raziky [13] and her colleagues found significantly higher EVR and SVR in patients treated with peginterferon alpha 2a [13]. Furthermore, Mauss et al [14] in published a study to estimate the likelihood of achieving SVR and they found that if patients were matched by baseline characteristics, treatment with peginterferon alpha 2a may be a positive predictor of SVR when compared to peginterferon alpha 2b [14].…”