Liver international : official journal of the International Association for the Study of the Liver · 2008
Predictors of a sustained virological response in patients with genotype 4 chronic hepatitis C.
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Gad Rita Raafat, Males Sylvia, El Makhzangy Hesham, Shouman Soheir, Hasan Aboubakr, Attala Mohamed, El Hoseiny Mostafa, Zalata Khaled, Abdel-Hamid Mohamed, Fontanet Arnaud, Mohamed Mostafa K, Esmat Gamal
Аннотация
OBJECTIVES: To determine the clinical, biological, virological and histological predictive factors associated with a sustained virological response (SVR) to combined interferon therapy among Egyptian patients infected by genotype 4 hepatitis C virus (HCV).
PATIENTS AND METHODS: Individual data from 250 patients with genotype 4 chronic hepatitis C, treated with different regimens of combined interferon, were analysed. The primary end point was SVR defined as undetectable HCV RNA by polymerase chain reaction (PCR) 24 weeks after the end of treatment. Multivariate logistic regression analysis was performed to select the independent prognostic parameters associated with SVR.
RESULTS: A sustained virological response was achieved among 137/250 (54.8%) patients. Baseline factors independently and negatively associated with SVR were serum alpha-fetoprotein (AFP) level (above 0.3 upper limit of normal) [odds ratio (OR)=0.5, 95% confidence interval (CI): 0.2-0.8], severe fibrosis (Metavir score >F2) (OR=0.4, 95% CI: 0.2-0.8), presence of steatosis (OR=0.5, 95% CI: 0.3-0.97) and standard interferon treatment (OR=0.4, 95% CI: 0.2-0.8).
CONCLUSIONS: Among genotype 4 chronic hepatitis C patients, severe fibrosis, severe steatosis, treatment with standard interferon and a high serum AFP level were all negatively associated with SVR. Pretreatment serum AFP level should be considered in the routine assessment of factors predictive of a treatment response.
PATIENTS AND METHODS: Individual data from 250 patients with genotype 4 chronic hepatitis C, treated with different regimens of combined interferon, were analysed. The primary end point was SVR defined as undetectable HCV RNA by polymerase chain reaction (PCR) 24 weeks after the end of treatment. Multivariate logistic regression analysis was performed to select the independent prognostic parameters associated with SVR.
RESULTS: A sustained virological response was achieved among 137/250 (54.8%) patients. Baseline factors independently and negatively associated with SVR were serum alpha-fetoprotein (AFP) level (above 0.3 upper limit of normal) [odds ratio (OR)=0.5, 95% confidence interval (CI): 0.2-0.8], severe fibrosis (Metavir score >F2) (OR=0.4, 95% CI: 0.2-0.8), presence of steatosis (OR=0.5, 95% CI: 0.3-0.97) and standard interferon treatment (OR=0.4, 95% CI: 0.2-0.8).
CONCLUSIONS: Among genotype 4 chronic hepatitis C patients, severe fibrosis, severe steatosis, treatment with standard interferon and a high serum AFP level were all negatively associated with SVR. Pretreatment serum AFP level should be considered in the routine assessment of factors predictive of a treatment response.
Предметные рубрики MeSH
AdultAntiviral AgentsFatty LiverFemaleFollow-Up StudiesGenotypeHepacivirusHepatitis C, ChronicHumansInterferon alpha-2Interferon-alphaLiver CirrhosisLogistic ModelsMaleMedication AdherenceMiddle AgedMultivariate AnalysisPolyethylene GlycolsRNA, ViralRandomized Controlled Trials as TopicRecombinant ProteinsRibavirinTreatment Outcomealpha-Fetoproteins