Identification of naïve HCV-1 patients with chronic hepatitis who may benefit from dual therapy with peg-interferon and ribavirin

Vito Di Marco, Antonio Craxi, Vincenza Calvaruso, Domenica Gioffreda, Mario Angelico, Antonio Massimo Ippolito, Giovanni Battista Gaeta, Michele Milella, Nicola Andriulli, Giovanna D'Andrea, Michele Barone, Teresa Santantonio, Giuseppina Brancaccio, Raffaele Cozzolongo, Filomena Morisco, Giuseppe Mazzella, Maria Lorena Abate, Martina Felder, Massimo Fasano, Maurizio MargaglioneAngelo Andriulli, Paolo Tundo, Giovanna Fattovich, Antonina Smedile, Pietro Gatti, Maria Rosa Valvano

Risultato della ricerca: Articlepeer review

28 Citazioni (Scopus)

Abstract

Background &amp; Aims The pool of HCV genotype 1 patients likely to be cured by peg-interferon and ribavirin remains to be quantified. Methods In 1045 patients treated with peg-interferon and ribavirin, two therapeutic strategies were confronted: the first one evaluated only baseline variables associated with sustained virological response (SVR), and the second one included the rapid virologic response (RVR) in addition to baseline predictors. An 80% SVR rate was the threshold to retain a strategy as clinically relevant. Results Overall, 414 patients (39.6%) attained SVR. In the first strategy, the hierarchy of features independently associated with SVR was IL28B CC genotype (OR 5.082; CI 3.637-7.101), low (<400,000 IU) viremia (OR 2.907; CI 2.111-4.004), F0-F2 fibrosis (OR 1.631; CI 1.122-2.372) and type 2 diabetes (OR 0.528; CI 0.286-0.972). In the alternative strategy, SVR was associated with RVR (OR 6.273; CI 4.274-9.208), IL28B CC genotype (OR 3.306; CI 2.301-4.751), low viremia (OR 2.175; CI 1.542-3.070), and F0-F2 fibrosis (OR 1.506; CI 1.012-2.242). Combining the favorable baseline variables, the rates of SVR ranged from 42.4% to 83.3%, but only 66 patients (6.3%, overall) with all predictors could be anticipated to reach the >80% SVR threshold. Only 26.6% of no-RVR patients attained SVR. Among the 255 RVR patients, the likelihood of SVR was 61.8% in those with unfavorable predictors, 80% in the presence of a single predictor, and 100% when both predictors were present. By using this model, 200 patients (19.1%) were predicted to have an 80% chance of being cured with dual therapy. Conclusions A consistent subset of naïve HCV-1 patients, identified by some baseline characteristics and RVR, may benefit from dual treatment with peg-interferon and ribavirin. © 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Lingua originaleEnglish
pagine (da-a)16-21
Numero di pagine6
RivistaJournal of Hepatology
Volume60
Stato di pubblicazionePublished - 2014

All Science Journal Classification (ASJC) codes

  • Hepatology

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