Ranking predictors of a sustained viral response for patients with chronic hepatitis C treated with pegylated interferon and ribavirin in Scotland

Innes, Hamish; Hutchinson, Sharon; Allen, Samuel H.; Bhattacharyya, Diptendu; Bramley, Peter; Carman, Bill; Delahooke, Toby; Dillon, John; Goldberg, David J.; Kennedy, N.; Mills, Peter R.; Morris, John; Morris, Joseph E.; Robertson, Chris; Stanley, Adrian J.; Hayes, Peter

doi:10.1097/meg.0b013e32835201a4

Cited by 29 publications

(29 citation statements)

References 31 publications

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“…Several investigators reported that increased γGT activity strongly associates with primary antiviral treatment failure [21,64,[67][68][69]. Weak trend of inverse SVR correlation with γGT activity was found in our study by univariate analysis too [OR 2.242 (0.956-5.259), p-0,063], but it was not confirmed by multivariate analysis.…”

Section: Discussioncontrasting

confidence: 51%

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Efficacy of Treatment With Pegylated Interferon and Ribavirin in Patients With Chronic HCV Infection “Under Real Life“ Conditions

Speičienė

Kotovienė

Mickevičius

et al. 2014

Medicinos Teorija Ir Praktika

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Objective. To investigate the outcomes of combined therapy of hepatitis C (HCV) patients with peginterferon and ribavirin in ”real life” practice, to compare them with data obtained in randomized clinical trials (RCT) and to evaluate possible predictors of sustained virological response (SVR). Material and methods. The retrospective study of HCV patients routinely examined and treated in the Vilnius University Hospital Santariskiu Klinikos (2003−2009 yrs) was carried out. They had undergone the treatment with combination of peginterferon alfa and ribavirin according to the Lithuanian guide. Overall 203 patients were enrolled. SVR was evaluated in 179 patients. Results. The overall rate of SVR was 43 %: in 51,3 % of naives (genotype 1 − 38,8 %, genotype 2 – 100 %, genotype 3 − 82,6 % cases) and in 28,1 % of experienced patients (genotype 1 – 17 %, and genotype 3 – 64,3 % cases). Significant relations of SVR and HCV genotype was observed: 68,9 % having genotype1 were non-responders, whereas 80 % and 75,7 % ones with genotype 2 and 3 achieved SVR (p 0.005 and p = 0.01, respectively). The inverse relation with the age (p 0.01), degree of fibrosis (p = 0.039) and previous unsuccessful treatment was confirmed by multivariate analysis. Conclusions. Data of SVR obtained „on real life“ conditions are non unambiguous: SVR of naive and experienced patients overall and those with genotype 1 were similar or slightly lower, while for patients with genotype 3 significantly higher than results presented in clinical trials. Genotype 1, previous unsuccessful antiviral treatment, older age, and advanced fibrosis were strongest negative predictors for SVR.

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Section: Discussioncontrasting

confidence: 51%

“…Some investigators found female gender as the positive predictor for SVR in RCT and in "real life condition"studies [9,24,25,56,63,64]. The others did not confirm these results [20,40,42,44,65], or even found that response to combined treatment and SVR in females 50 years old or older was poorer than in males [66].…”

Section: Discussionmentioning

confidence: 65%

Efficacy of Treatment With Pegylated Interferon and Ribavirin in Patients With Chronic HCV Infection “Under Real Life“ Conditions

Speičienė

Kotovienė

Mickevičius

et al. 2014

Medicinos Teorija Ir Praktika

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“…This risk behaviour research has, however, informed the need to fully understand the extent of testing and diagnosis of PWID post-SVR. Additionally, SVR patients account for roughly 60% of the overall treated population, and we therefore did not report on the behaviours of remaining 40% who were treated and did not attain the optimal outcome (Innes, et al, 2012). This leaves scope for further research using such a comparison group.…”

Section: Discussionmentioning

confidence: 99%

“…Year of SVR was categorised for descriptive analysis (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012), and kept continuous for statistical modelling. Patients who were cirrhotic at time of treatment initiation were identified by the Clinical Database, based on a combination of (i) clinical examination; (ii) radiology (ultrasound, transient elastography, computed tomography, or magnetic resonance imaging); or (iii) liver biopsy, as previously described (Innes, et al, 2012).…”

Section: Explanatory Variablesmentioning

confidence: 99%

Evidence of continued injecting drug use after attaining sustained treatment-induced clearance of the hepatitis C virus: Implications for reinfection

Valerio

Goldberg

Lewsey

et al. 2015

Drug and Alcohol Dependence

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Background: People who inject drugs (PWID) are at the greatest risk of hepatitis C virus (HCV) infection, yet are often denied immediate treatment due to fears of on-going risk behaviour. Our principle objective was to examine evidence of continued injecting drug use among PWID following successful treatment for HCV and attainment of a sustained viral response (SVR). Methods: PWID who attained SVR between 1992 and June 2012 were selected from the National Scottish Hepatitis C Clinical Database. Hospitalisation and mortality records were sourced for these patients using record-linkage techniques. Our primary outcome variable was any hospitalisation or death which was indicative of injecting drugs post-SVR. Results: The cohort comprised 1170 PWID (mean age at SVR 39.6y; 76% male). The Kaplan Meier estimate of incurring the primary outcome after three years of SVR was 10.6% (95% CI, 8.8-12.8) After adjusting for confounding, the risk of an injection related hospital episode or death post-SVR was significantly increased with advancing year of SVR: AHR:1.1 per year (95% CI, 1.0-1.2), having a pre-SVR acute alcohol-related hospital episode: AHR:1.8 (95% CI, 1.3 -2.6), and having a pre-SVR opiate or injection-related hospital episode: AHR:2.6 (95% CI, 1.9 -3.7). Conclusion: Despite attaining the optimal treatment outcome, these data indicate that an increasing significant number of PWID continue to inject post-SVR at an intensity which leads to either hospitalisation or death and potential increased risk of reinfection.Pg|2

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“…616.36-002-085 Med čas (Krag) / Med J (Krag) 2014; 48(3): 113-121. bolesnicima s nepovoljnim odgovorom na terapiju (rr/nr). Ovakav nalaz potvrđen je i u drugim studijama koje su se bavile istraživanjem prediktora terapijskog odgovora (43,53,54). u skladu s ovim podacima, serumske vrednosti aminotransferaza, koje se smatraju vrlo osetljivim indeksom nekroze ćelija jetre, odnosno specifičnim parametrom hepatocelularnog oštećenja, niže su u grupi pacijenata sa nižim stepenom fibroze, a to su pacijenti sa pozitivnim odgovorom na terapiju (SVr i ETr) u odnosu na grupu bolesnika sa višim stepenom fibroze koja je karakteristična za pacijente sa negativnim odgovorom na terapiju (nr/rr).…”

Section: Diskusijaunclassified

10.5937/mckg48-5925 = Therapy of chronic HCV infection: Association between virological response and predictive factors

Vuković¹,

Mijailović²,

Popović³

et al. 2014

Medicinski casopis

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Ranking predictors of a sustained viral response for patients with chronic hepatitis C treated with pegylated interferon and ribavirin in Scotland

Cited by 29 publications

References 31 publications

Efficacy of Treatment With Pegylated Interferon and Ribavirin in Patients With Chronic HCV Infection “Under Real Life“ Conditions

Efficacy of Treatment With Pegylated Interferon and Ribavirin in Patients With Chronic HCV Infection “Under Real Life“ Conditions

Evidence of continued injecting drug use after attaining sustained treatment-induced clearance of the hepatitis C virus: Implications for reinfection

10.5937/mckg48-5925 = Therapy of chronic HCV infection: Association between virological response and predictive factors

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