Wednesday, February 2, 2011

Hepatitis C;Simple formula to predict response to peginterferon/Ribavirin Geno 1

Source: Hepatol Res

Simple formula to predict response to peginterferon alpha2b and ribavirin combination therapy in genotype 1 chronic hepatitis C patients with high viral loads

Itoh Y, Nishimura T, Hashimoto H, Yamaguchi K, Niimi T, Yokomizo C, Fujii H, Minami M, Yasui K, Mitsuyoshi H, Okanoue T, Takehara T, Hiasa Y, Onji M, Yoshikawa T; Hepatology Research 41 (2), 126-132 (Feb 2011)

Aim:  We advocate a simple formula which can conveniently predict the outcome of Peg-interferon (IFN) alpha2b and ribavirin (RBV) combination therapy for genotype 1 chronic hepatitis C (CH-C) with high viral load.

Methods:  A total of 338 (group A: 230, Group B: 108) genotype 1 CH-C patients treated with Peg-IFN alfa-2b and RBV were enrolled.

Clinical parameters differing significantly between sustained virological responders (SVRs) and non-SVRs in group A were categorized, then a simple formula to predict SVR was constructed and re-evaluated in group B.

Another formula containing hepatitis C virus amino acid mutations/substitutions also was constructed. Results:  In group A, gender and HCV RNA load<1000 KIU were significant predictors of SVR by multivariate logistic regression analysis.

A simple formula was constructed (formula A): male gender (point 2) + HCV RNA load<1000 KIU (3) + platelet counts ≥15 × 10(4) /mm(3) (1) + age<60 (1).

In group A, score (0-1) predicted SVR rate 23.8% (2-4): 48.1% and (5-7): 70.2%. According to this formula, score (0-1) predicted SVR rate 7.1% (2-4): 38.6%, and (5-7): 70.3% in group B. Information on HCV amino acid mutations/substitutions seemed to add some accuracy.

Conclusions:  This simple formula can be used to roughly determine, at the patients' first/second visit, the probability of response to Peg-IFN alpha2b and RBV combination therapy for genotype 1 CH-C with high viral load.

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