Predicting sustained virological response in chronic hep C therapy

Predicting sustained virological response in chronic hep C therapy

A study in the recently published Journal of Viral Hepatitis estimates the likelihood of sustained virological response in chronic hepatitis C therapy.

The likelihood of a sustained virological response is the most important factor for physicians and patients in the decision to initiate and continue therapy for chronic hepatitis C infection.

Dr Stefan Mauss and colleagues from Germany identified predictive factors for sustained virological response with peginterferon plus ribavirin in patients with chronic hepatitis C 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 ribavirin between the years 2000 and 2007.

To ensure comparability regarding peginterferon therapies, patients were analyzed in pairs matched by several baseline variables.
Sustained virological response rates were 58% overall
Journal of Viral Hepatitis

The researchers determined the effect of nonmatched baseline variables and treatment modality on sustained virological response.

Among 2378 patients, sustained virological response rates were 58% overall, 47% in HCV genotype 1/4-infected patients and 77% in genotype 2/3-infected patients.

In multivariate logistic regression analysis, positive predictors of sustained virological response were HCV genotype 2 infection, HCV genotype 3 infection, low baseline viral load and treatment with peginterferon alfa-2a.

The research team found that the negative predictors of sustained virological response were higher age, elevated baseline gamma-glutamyl transpeptidase and low baseline platelet count.

Dr Mauss' team commented, "Among patients treated with peginterferon plus ribavirin in routine clinical practice, genotype, baseline viral load, age, gamma-glutamyl transpeptidase 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 sustained virological response when compared to peginterferon alfa-2b."


http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2893.2010.01372.x/abstract