Predictors of early and sustained virological response of viral hepatitis C (original) (raw)
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Gastroenterology, 2009
Chronic hepatitis C (HCV) affects more than 180 million people worldwide and it is the leading cause of liver disease in Middle East with the prevalence up to 20% in some populations. As one of the most important infectious diseases, it causes around 250,000 deaths per year. Liver cirrhosis eventuates in 20% to 30% patients with chronic HCV infection. HCV was estimated to be attributable to one third of hepatocellular carcinoma cases globally. The aim of this study was to detect liver enzymes and virologic response to combined Pegylatedinterferon-alfa (PEG-IFN)-ribavirin therapy in Saudi chronic hepatitis C infected patients. One hundred patients with chronic HCV infection who have anti HCV antibodies detected by ELISA were selected to undergo Real-Time polymerase chain reaction (RT-PCR) and liver enzymes serum levels of aspirate aminotransferase (AST) and alanine aminotransferase (ALT) before starting treatment with combined pegylated interferon-ribavirin therapy, RT-PCR after 12 weeks of starting of treatment and RT-PCR and liver enzymes after 24 weeks of anti-viral treatment. Results revealed After 12 weeks of anti-viral treatment, RT-PCR was done on 5 resisted cases and as a result their treatment has been stopped, where 95 cases were sensitive, so they continued their combined pegylated interferon-ribavirin therapy. However, after 24 weeks of anti-viral treatment RT-PCR, AST and ALT were done again and 12 patients were resisted cases and 83 patients were sensitive to combined pegylated interferon-ribavirin therapy, also, there were statistical significant reduction in the mean values of AST and ALT after 24 weeks of anti-viral treatment. Conclusion: Combined Pegylatedinterferon-alfa (PEG-IFN)-ribavirin therapy is an effective treatment strategy for Saudi chronic hepatitis C infected patients.
PRILOZI, 2017
Introduction: The success of the antiviral treatment in patients with chronic hepatitis C depends on the factors related to the virus and the host. The aim of the study is the analysis of the antiviral therapy which is a combination of pegylated interferon and ribavirin, considering various factors that will identify the predictors of the sustained virological response. Material and Methods: This retrospective study included 226 patients, divided in two groups. Patients with sustained virological response and patients without sustained virological response were compared in terms of the following factors: genotype, viral load, gender, age, inflammatory and fibrotic changes in the liver, metabolic abnormalities, obesity and fatty liver. Results: The rate of the sustained virological response is 83.6%, more frequently in patients with genotype 3, with evidenced statistical significance (90.54%). The factors that significantly contribute to sustained virological response are related to ...
2014
Hepatitis C virus infection is the most common chronic blood-borne infection and one of the most important causes of chronic liver disease. Knowing the predictors associated with pegylated interferon/ribavirin (PEG-IFN/RBV) combination therapy response is important for evidence-based treatment recommendations. The goal of this study was to identify host and viral factors of response to PEG-IFN/RBV treatment in chronic hepatitis C genotype 1b patients. We have examined the relationship between gender, age, level of alanine aminotransferase (ALT), viral load and liver fibrosis progression on therapy response. ALT level and viral load were evaluated before starting treatment with combination therapy. The elevated levels of ALT and route of HCV transmission were found to be significantly associated with the response to therapy in HCV-infected patients. Our findings may be useful for estimating a patient's likelihood of achieving sustained viral response.
2009
BACKGROUND AND OBJECTIVES:Knowledge of the predictors of sustained viral response (SVR) to pegylated interferon (PEG-INF) alfa-2a and ribavirin (RBV) therapy in patients with hepatitis C genotype-4 (HCV-4) is crucial for selecting patients who would benefit most from therapy. We assessed the predictors of SVR to this combination therapy in Saudi patients with chronic HCV-4 infection.PATIENTS AND METHODS:This retrospective study included 148 patients with HCV-4 infection who underwent clinical, biochemical and virological assessments before treatment and at 12, 24, 48 and 72 weeks post-treatment.RESULTS:Of the 148 patients, 90 (60.8%) were males. Mean (SD) for age was 48.5 (12.7) years and BMI was 27.9 (7.5) kg/m2. Seventy-nine of 148 (60.1%) patients were treatment naïve and 110 (74.3%) underwent pre-treatment liver biopsy. Eighteen (12.2%) patients did not complete therapy because of side effects or they were lost to follow up. Early virological response was achieved in 84 of 91 (92.3%) patients. In the 130 (87.8%) patients who completed therapy, 34 (26.2%) were non-responders and 96 (63.8%) achieved end-of-treatment virological response (ETVR). SVR and virological relapse (24 weeks after ETVR) occurred in 66/130 (50.7%) and 30/130 (31.2%) patients, respectively. Compared to relapsers, sustained responders were significantly younger (P=.005), non-diabetic (P=.005), had higher serum albumin (P=.028), lower alpha-fetoprotein level (P=.026), lower aspartate aminotransferase (AST) (P=.04) levels, and were treatment-naivve (P=.008). In a multivariate regression analysis, the independent predictors of SVR were younger age (P=.016), lower serum AST (P=.012), and being treatment naivve (P=.021).CONCLUSION:Approximately half of HCV-4 patients who complete the course of combination therapy achieve an SVR, especially if they are young, treatment naivve and have lower AST levels.
IOSR Journal of Pharmacy (IOSRPHR), 2014
standard of care for the treatment of chronic hepatitis C is combination therapy with Pegylated Interferon and Ribavirin (RBV). There currently exists no systematic explanation for these genotypespecific differences in clinical outcome. Furthermore, whether factors that govern outcome for one genotype play a similar role in other genotype remains to be fully explored. Hence, the present study was taken in consideration of the factors emphasizing their impact on the sustained virological response (SVR) against HCV genotypes.
American Journal of Clinical Medicine Research, 2013
A combination therapy with pegylated interferon (PEG-IFN) plus ribavirin (RBV) has made it possible to achieve a sustained virological response (SVR) of 50% in refractory cases with genotype 1b and high levels of plasma HCVRNA. Several factors including virus mutation and host factors such as age, gender, fibrosis of the liver, lipid metabolism, innate immunity, and single nucleotide polymorphism (SNPs) are reported to be correlated to therapeutic effects. However, it is difficult to determine which factor is the most important predictor for an individual patient. Data mining analysis is useful for combining all these together to predict the therapeutic effects, It is important to analyze blood tests and to predict therapeutic effects prior to initiating treatment. Our aim is to determine the independent contribution of factors including age, gender, viral load, liver fibrosis, hepatitis activity index sore, and the homeostasis model assessment of insulin resistance (HOMA-IR) score in predicting response to therapy in chronic hepatitis C (CHC). Multivariate analysis of factors predicting rapid (RVR) and sustained (SVR) virological response in 280 consecutive, treatment-naive CHC patients treated with peginterferon alpha and ribavirin in a prospective multicentre study.