Predictive value of early virological response to treatment with different interferon-based regimens plus ribavirin in patients with chronic hepatitis C
- PMID: 15782622
Predictive value of early virological response to treatment with different interferon-based regimens plus ribavirin in patients with chronic hepatitis C
Abstract
Early virological response (EVR) to different interferon-based regimens plus ribavirin and its ability to predict the outcome of therapy in patients with chronic hepatitis C were investigated. The study design was as follows: 64 naive patients were considered, 32/64 received pegylated interferon alpha-2b (Peg-IFN-alpha2b) plus ribavirin and the remaining 32 received leucocyte interferon alpha (IFN-alpha) plus ribavirin. At week 4 of treatment, EVR was present in 68.7% and 37.5% of patients treated with Peg-IFN-alpha2b plus ribavirin, and with leucocyte interferon alpha (IFN-alpha) plus ribavirin, respectively (p = 0.024). At week 12, the cumulative EVR rates did not differ between the two groups (71.9% vs 56.2%, p >0.05) because a higher proportion of patients achieved EVR for the first time after more than 4 weeks of therapy in the standard IFN-alpha group. Sustained virological response (SVR) rates, however, resulted significantly higher in the Peg-IFN-alpha2b group (65.6% vs 37.5%; p = 0.045) since a higher proportion of patients who received standard IFN-alpha relapsed during the follow-up. In the standard IFN-alpha group, HCV genotype 1 (p = 0.035), high baseline viral load (p = 0.035) and the presence of bridging fibrosis/cirrhosis (p = 0.011) were closely associated with significantly lower SVR rates. In the Peg-IFN-alpha2b group, only bridging fibrosis/cirrhosis (p = 0.02) negatively influenced the outcome of treatment. Overall, 33/41 (80.5%) patients with EVR at week 12 were sustained responders, yielding a positive predictive value (PPV) of 0.80. However, when SVR was related to the time taken to reach EVR, 32/34 (94.1%) patients with EVR at week 4 of therapy (PPV = 0.94) versus 1/7 (14.3%) patients who had EVR after more than 4 weeks of therapy (PPV = 0.14) resulted sustained responders (p = 0.000057). In conclusion, EVR at week 4 of treatment is strongly associated with the likelihood of achieving SVR, regardless of the therapeutic regimen. However, when compared with standard IFN-alpha plus ribavirin, treatment with Peg-IFN-alpha2b plus ribavirin significantly increases the probability of viral clearance within the first 4 weeks of treatment. Finally, patients who do not clear the virus within the first 12 weeks of treatment have no chance of achieving SVR, justifying discontinuation of therapy in these patients.
Similar articles
-
Pegylated alpha-interferon-2a plus ribavirin compared with pegylated alpha-interferon-2b plus ribavirin for initial treatment of chronic hepatitis C virus: prospective, non-randomized study.J Gastroenterol Hepatol. 2008 Jun;23(6):861-6. doi: 10.1111/j.1440-1746.2008.05397.x. Epub 2008 Apr 19. J Gastroenterol Hepatol. 2008. PMID: 18422960 Clinical Trial.
-
The use of different Peg-interferon alpha-2b regimens plus ribavirin in HCV-1b-infected patients after rapid virological response does not affect the achievement of sustained virological response.J Viral Hepat. 2008 Apr;15(4):300-4. doi: 10.1111/j.1365-2893.2007.00944.x. J Viral Hepat. 2008. PMID: 18307592 Clinical Trial.
-
Predictive value of rapid virological response and early virological response on sustained virological response in HCV patients treated with pegylated interferon alpha-2a and ribavirin.J Gastroenterol Hepatol. 2007 Jun;22(6):832-6. doi: 10.1111/j.1440-1746.2007.04904.x. J Gastroenterol Hepatol. 2007. PMID: 17565637
-
Financial impact of two different ways of evaluating early virological response to peginterferon-alpha-2b plus ribavirin therapy in treatment-naive patients with chronic hepatitis C virus genotype 1.Pharmacoeconomics. 2005;23(10):1043-55. doi: 10.2165/00019053-200523100-00007. Pharmacoeconomics. 2005. PMID: 16235977 Review.
-
Pegylated interferon alpha-2a and -2b in combination with ribavirin in the treatment of chronic hepatitis C: a systematic review and economic evaluation.Health Technol Assess. 2004 Oct;8(39):iii-iv, 1-125. doi: 10.3310/hta8390. Health Technol Assess. 2004. PMID: 15461877 Review.
Cited by
-
Clinical Evaluation of Terap C Vaccine in Combined Treatment with Interferon and Ribavirin in Patients with Hepatitis C.Curr Ther Res Clin Exp. 2017 Apr 27;85:20-28. doi: 10.1016/j.curtheres.2017.04.006. eCollection 2017. Curr Ther Res Clin Exp. 2017. PMID: 29158855 Free PMC article.
-
Peginterferon plus ribavirin versus interferon plus ribavirin for chronic hepatitis C.Cochrane Database Syst Rev. 2014 Feb 28;2014(2):CD005441. doi: 10.1002/14651858.CD005441.pub3. Cochrane Database Syst Rev. 2014. PMID: 24585509 Free PMC article. Review.
-
The interaction between insulin resistance, liver fibrosis and early virological response in Egyptian patients with chronic hepatitis C.Can J Gastroenterol. 2012 Jun;26(6):325-9. doi: 10.1155/2012/291457. Can J Gastroenterol. 2012. PMID: 22720272 Free PMC article.
-
Natural leukocyte interferon alpha (Alfaferone) combined with ribavirin in the treatment of patients with HCV-related cirrhosis: our experience.Infection. 2011 Oct;39(5):433-7. doi: 10.1007/s15010-011-0135-3. Epub 2011 Jul 8. Infection. 2011. PMID: 21739360 Free PMC article.
Publication types
MeSH terms
Substances
LinkOut - more resources
Medical