Sustained virological response in a predominantly hepatitis C virus genotype 4 infected population

Abstract

AIM:To assess sustained virological response (SVR) rates in a predominantly hepatitis C virus (HCV) genotype 4 infected population. Between 2003Between -2007 patients who were treated for chronic hepatitis C infection at our center were included. Epidemiological data, viral genotypes, and treatment outcomes were evaluated in all treated patients. Patients with chronic renal failure, previous non-responders, and those who relapsed after previous treatment were excluded from the study. Among all patients, 57% were treated with PEGinterferon (IFN) a-2a and 43% patients were treated with PEG-IFN a-2b; both groups received a standard dose of ribavirin. METHODS: RESULTS:89.6% of patients completed the treatment with an overall SVR rate of 58%. The SVR rate was 54% in genotype 1, 44% in genotype 2, 73% in genotype 3, and 59% in genotype 4 patients. There was no statistical difference in the SVR rate between patients treated with PEG-IFN a-2a and PEG-IFN a-2b (61.5% vs 53%). Patients younger than 40 years had higher SVR rates than older patients (75% vs 51%, P = 0.001). SVR was also statistically significantly higher when the HCV RNA load (pretreatment) was below 800.000 (64% vs 50%, P = 0.023), in patients with a body mass index (BMI) less than 28 (65% vs 49%, P = 0.01), and in patients who completed the treatment duration (64% vs 8%, P ≤ 0.00001). CONCLUSION:The SVR rate in our study is higher than in previous studies. Compliance with the standard duration of treatment, higher ribavirin dose, younger age, lower BMI, and low pretreatment RNA levels were associated with a higher virological response.

Prediction of Sustained Virological Response to Combination Therapy with Pegylated Interferon Alfa and Ribavirin in Patients with Genotype 3 Chronic Hepatitis C

“…In most of the studies, the SVR rates vary from 44 to 83%, with higher SVR rates in HCV genotype 2 and 3. Studies indicate that, among patients infected with HCV genotype 3, SVR was achieved in 68-83% patients [20][21][22][23][24][25]. However, studies carried out in the Indian population have shown poor response to therapy [6,27,28].…”

“…Other factors, with lesser impact, include age, gender, race, bodyweight/body mass index (BMI), and the degree of fibrosis [10,11,[13][14][15][16][17][18][19]. Treatment with PEG-IFN and RBV in CHC yields SVR rates of 44-83%, with higher SVR rates seen in patients infected with HCV genotypes 2 and 3 [20][21][22][23][24][25].…”

Management of hepatitis C virus genotype 4: Recommendations of An International Expert Panel

“…With the introduction of pegylated IFN compounds in combination with ribavirin, the efficacy of treatment in HCV-4 further improved significantly. In various studies from European and Middle Eastern countries, SVR rates ranging from 43% to 70% were reported [39,40,53,[75][76][77][78][79][80][81][82][83][84][85][86][87][88]73,[89][90][91] (Table 1). These results are indeed higher than those (42-46%) achieved in genotype 1 patients but still lower than those (76-82%) reported in chronic hepatitis C genotype 2 and 3.…”

Genotype 4 Hepatitis C Virus Responds Worse than Genotype 1 to 48-Week Combination Treatment with Pegylated Interferon Alpha Plus Ribavirin: a Greek Multi-Centered Study

“…Data for the efficacy of standard combination therapy with Peg-IFNα plus ribavirin in genotype 4 comes mainly from endemic areas such as Egypt [8,9,12,14], Saudi Arabia [10], Kuwait [13] and Quatar [11]. The reported SVRs range between 59.7 and 67.8%.…”

“…Data on the efficacy of current combination therapy with pegylated interferon-α (Peg-IFNα) plus weight-based ribavirin is limited and contradictory; sustained virological response (SVR) rates of more than 60% reported in endemic areas [8][9][10][11][12][13][14] are approximately two times higher than those encountered in Europe [15][16][17]. In Greece, genotype 4 accounts for about 15% of all HCV infections [18][19][20][21][22] and is generally considered as "difficult to treat" in everyday clinical practice.…”