Friday, February 4, 2011

Hepatitis C; FibroTest is a validated non-invasive marker of fibrosis in treatment-naive patients.

FibroTest predicts virologic response in retreated HCV

FibroTest is an independent predictor of virologic response in chronic HCV patients retreated with pegylated interferon alfa-2b and ribavirin, finds February's Journal of Hepatology.

EPIC-3 is a prospective, international study that has demonstrated the efficacy of pegylated-intereron alfa-2b plus weight-based ribavirin in patients with chronic hepatitis C and significant fibrosis who previously failed any interferon–alfa/ribavirin therapy.

Dr Thierry Poynard and colleagues from France assessed FibroTest as a possible alternative to biopsy as the baseline predictor of subsequent early virologic, and sustained virologic response in previously treated patients.

Of 2312 patients enrolled, 1459 had an available baseline FibroTest, biopsy, and complete data.

58% achieving sustained virological response
Journal Hepatology
The research team observed that baseline characteristics were similar as in the overall population.

The team reported that 35% of patients had undetectable Hepatitis C virus-RNA at TW12 (TW12neg), with 58% achieving sustained virological response.

The accuracy of FibroTest was similar to that in naive patients.

The team found that the area under receiving operating characteristic curve for the diagnosis of F4 vs F2 was 0.8.

The researchers noted that 5 baseline factors were associated with sustained virological response.

The associated baseline factors included fibrosis stage estimated using FibroTest or biopsy, genotype 2/3, baseline viral load, prior relapse, and previous treatment with non-pegylated-interferon.

These same factors were associated with early virological response.

Among patients TW12neg, 2 independent factors remained highly predictive of sustained virological response.

The 2 independent factors included genotype 2/3, fibrosis estimated with FibroTest or by biopsy.

Dr concludes, "FibroTest at baseline is a possible non-invasive alternative to biopsy for the prediction of early virological response at 12 weeks.

"It is also an alternative to biopsy for the prediction of sustained virological response in patients with previous failures and advanced fibrosis, retreated with pegylated-interferon alfa-2b and ribavirin."

J Hepatol 2011: 54(2): 227-23504 February 2011

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