Predictive Factors For Sustained Virological Response In The Treatment Of Patients With Chronic Hepatitis C

Background: The goal of antiviral therapy in patients with chronic hepatitis C is to prevent progression of the disease. The most important treatment response is the absence of viral RNA six months after discontinuation the therapy, defined as the sustained virological response (SVR). Successful therapy depends on many factors that are in association with the virus itself and/or infected person. The aim of the investigation was identifying some characteristics of the patients and hepatitis C virus as pre-treatment predictive factors for achieving SVR. Methods: Total of 364 treatment-naïve patients was enrolled in the study (60.4% were males; age from 16 yr-65 yr, mean 42.18, SD ± 11.71). Liver cirrhosis had 21.7% of patients. Patients were treated with standard doses of pegylated interferon alpha and ribavirin during 6 to 12 months depending on the genotype in the period from January, 2004 to January, 2009. Source of infection was blood transfusion, intravenous drug abuse, accidental injury and unknown in 26.5%, 19.5%, 12%, and 42% of patients, respectively. Genotype distribution revealed genotype 1, 3, and 4 in 56.8%, 26.7% and 5% of patients, respectively. The minority of patients had genotype 2 and/or mixed genotypes (1b3a, 1b4). Detection and quantification of viral RNA with commercial assay (Cobas Amplicor HCV Monitor v2, Roche Molecular Systems) was evaluated before treatment, after treatment and six months later. Electronic data base (SPSS for Windows V11.0) was used for statistical analysis. Results: Total of 82.8% of patients were negative (HCV RNA < 50 IU/mL) after treatment while SVR was achieved in 68.8% of patients. Binary logistic regression analysis revealed intravenous drug abuse (p = .005) and genotype 3 (p = .003) as positive, whereas age older than 40 (p = .000), presence of cirrhosis (p = .039), and genotype 1 (p = .000) were negative predictor factors for SVR. In multivariate analysis, age older than 40 (p = .001) and genotype 1 (p = .000) were significant variables (Exp(B) = .351 vs. .233). Conclusion: Successful virological response to therapy is expected in patients with genotype 3 and intravenous drug users. Presence of genotype 1 is the most important negative predictor for treatment of patients with chronic hepatitis C. Abstracts for SupplementInternational Journal of Infectious DiseasesVol. 14Preview Full-Text PDF Open Archive