Who is more likely to respond to dual treatment with pegylated-interferon and ribavirin for chronic hepatitis C? A gender-oriented analysis.

We assessed, in real-life practice, viral, demographic,genetic and metabolic factors influencing the sustainedvirologic response (SVR), with a gender-orientedanalysis, in patients with chronic hepatitis C virus (HCV)treated with pegylated interferon and ribavirin. Six hundredand seventy na€ıve patients were treated with dual therapyand evaluated by gender and HCV genotype. Associationsbetween baseline variables and SVR were assessed by multivariatelogistic regression analysis. Among 362 genotype 1patients, SVR was achieved in 158 patients (44%), and SVRwas independently associated with age less than 50 years(OR 2.12; 95% CI 1.09–4.30; P = 0.039) and C/C genotypers12979860 SNP (OR 2.83; 1.19–6.74; P = 0.002) in 163females, while absence of visceral obesity (OR 2.491; 1.131–5.487; P = 0.023), HCV-RNA lower than 400 000 IU/mL(OR 2.66; 1.273–5.558; P = 0.009) and C/C genotypers12979860 SNP (OR 4.969; 2.401–10.283; P < 0.001)were independently associated with SVR in 199 males. Combiningfavourable baseline variables, the probability ofobtaining SVR ranged from 27.6% to 84.2% in females, andfrom 14.3% to 85.7% in males. The rate of SVR was 81.1%in 175 genotype 2 patients, and 69% in 100 genotype 3patients. Rapid virologic response was the only valid predictorof SVR regardless of other features. In conclusions, in thesetting of HCV genotype 1, chronic hepatitis, combiningrapid virologic response and predictive factors, which are differentfor females and males, allows clinicians to single out agroup of patients whose likelihood of SVR exceeds 80%. Forthese patients, triple therapy with first-generation proteaseinhibitors may be unwarranted.