Prediction of Sustained Virological Response to Combination Therapy with Pegylated Interferon Alfa and Ribavirin in Patients with Genotype 3 Chronic Hepatitis C

Introduction. Dual antiviral therapy with pegylated interferon alfa-2a and ribavirin leads do sustained elimination of hepatitis C virus infection in over 50% patients with genotypes 1 and 4 and in over 80% with genotypes 2 and 3. In addition to genotype, for predicting success of therapy, important factors are baseline HCV RNA level, age, sex, stage of fibrosis, insulin resistance, degree of fat in liver, and patient?s weight and genetics. Also, adherence to therapy could be a very important factor associated with success of therapy. Objective. The aim of this study was to assess importance of therapy adherence and reduced doses of pegylated interferon alfa-2a and ribavirin on sustained virological response. Methods. One hundred and sixteen patients with chronic hepatitis C were analyzed. Sustained virological response was analyzed in relation to whether the patients received a full cumulative dose of pegylated interferon alfa-2a, a full cumulative dose of pegylated interferon alfa-2a and ribavirin, and a full cumulative dose of pegylated interferon alfa-2a and at least 60% the expected cumulative dose of ribavirin. Results. At the end of the follow-up period, sustained virological response was achieved in 26 (96.3%) patients who received full cumulative dose of pegylated interferon alfa-2a and in 66 (74.2%) who did not (p<0.05). Sustained virological response was achieved in 18 (94.7%) patients who received full cumulative dose of pegylated inteferon alfa-2a and ribavirin, and in 73 (76%) who did not (p<0.05). Sustained virological response was achieved in 25 (96.2%) patients who received full cumulative dose of pegylated inteferon alfa-2a and at least 60% of cumulative dose of ribavirin and in 66 (74.2%) who did not (p<0.05). Conclusion. These findings indicate that adherence to therapy for chronic hepatitis C is a very important factor for achieving sustained virological response.

Download Full-text

Treatment history: Factors that affect the outcome of hepatitis c virus treatment with interferon-alpha 2a/b and ribavirin

Medicinski pregled ◽

10.2298/mpns1804114s ◽

2018 ◽

Vol 71 (3-4) ◽

pp. 114-120

Author(s):

Tijana Spasojevic ◽

Nevenka Bujandric ◽

Milos Vujanovic

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Sustained Virological Response ◽

Chronic Hepatitis C ◽

Virological Response ◽

Pegylated Interferon ◽

Interferon Alfa ◽

Genotype 1 ◽

Extrahepatic Manifestations ◽

Pegylated Interferon Alfa

Introduction. Until the 1990s, there was no available treatment for chronic hepatitis C, but during this decade the benefits of interferon-alfa therapy were reported. At the end of the 1990s, the pegylated interferon-alfa 2a/b has significantly altered the treatment, whereas direct acting antivirals have significantly affected the treatment. The aim of this study was to show the most significant predictive factors of therapy response among patients with chronic hepatitis C treated with pegylated interferon- alfa 2a/b and ribavirin. Material and Methods. A non-randomized retrospective study included 292 patients with chronic hepatitis C treated at the Clinic for Infectious Diseases, Clinical Center of Vojvodina, from 2008 to 2015. Results. The study showed that therapeutic response was not affected by sex, serum viral load, or if the therapy was applied for the first time or repeated. A sustained virological response was statistically significantly more frequent in younger patients, as well as in patients without extrahepatic manifestations. Cases with higher progression of fibrosis were associated with lower chance for sustained virological response. Genotype 1 showed to be a predictor of adverse response to therapy, and genotype 3 as a predictor of sustained virological response. Steatosis was significantly less frequent in patients with genotype 1 with sustained virological response. Patients with a shorter duration of infection were more prone to sustained virological response. Conclusion. A positive response to pegylated interferon-alfa 2a/b and ribavirin was found in 70.20% of patients with chronic hepatitis C. Elderly age, late detection of the infection, hepatitis C virus 1 genotype, fibrosis progression, presence of hepatic steatosis, and extrahepatic manifestations were risk factors for poor treatment outcome.

Download Full-text