Tuesday, August 30, 2011

Hepatitis C; Response To Treatment Geno 3-fibrosis but not race encourages relapse

European Journal of Gastroenterology & Hepatology:
September 2011 - Volume 23 - Issue 9 - p 747–753
doi: 10.1097/MEG.0b013e3283488aba

Original Articles: Hepatitis

Response to antiviral therapy in patients with genotype 3 chronic hepatitis C: fibrosis but not race encourages relapse

Shoeb, Daniaa; Rowe, Ian A.b; Freshwater, Dennisb; Mutimer, Davidb; Brown, Ashleyc; Moreea, Sullemand; Sood, Ruchitd; Marley, Richarda; Sabin, Caroline A.e; Foster, Graham R.a

Abstract
Background and aims:
We completed a retrospective analysis of patients with genotype 3 hepatitis C virus (HCV) undergoing therapy in four UK centres with large populations of patients from the Indian subcontinent.

Materials and methods:
Notes on all patients treated with pegylated interferon and ribavirin were reviewed and factors that influenced the response were examined.

Results:
Six hundred and four patients with genotype 3 HCV were studied, of whom 299 were Asians. Median age was 43 years, 65% were men and 24% had cirrhosis. Overall, 457 (76%) patients achieved sustained virological response (SVR). By multivariable analysis it was found that ethnicity was not associated with an impaired response but age, cirrhosis and diabetes were significantly associated with a reduced SVR, the likelihood of a response was reduced by 25% per 10-year increment in age, by 59% among individuals with cirrhosis and by 62% among individuals with diabetes mellitus. Most patients who did not achieve an SVR relapsed (15%) rather than failing to achieve an end of treatment response.

Conclusion:
The response to antiviral therapy in genotype 3 HCV is not affected by South Asian (vs. Caucasian) ethnicity, but age, cirrhosis and diabetes reduce the response. Treatment failure most often is due to relapse.

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