Estimating the likelihood of sustained virological response in chronic hepatitis C therapy

Journal of Viral Hepatitis
doi: 10.1111/j.1365-2893.2010.01372.x

Mauss, S., Hueppe, D., John, C., Goelz, J., Heyne, R., Moeller, B., Link, R., Teuber, G., Herrmann, A., Spelter, M., Wollschlaeger, S., Baumgarten, A., Simon, K.-G., Dikopoulos, N. and Witthoeft, T.

*Correspondence: Dr. Stefan Mauss, Center for HIV and Hepatogastroenterology, Grafenberger Allee 128a, 40237 Duesseldorf, Germany. E-mail: stefan.mauss@center-duesseldorf.de

Article first published online: 16 SEP 2010
Received March 2010; accepted for publication July 2010

Abstract

Summary. The likelihood of a sustained virological response (SVR) is the most important factor for physicians and patients in the decision to initiate and continue therapy for chronic hepatitis C (CHC) infection. This study identified predictive factors for SVR with peginterferon plus ribavirin (RBV) in patients with CHC treated under ‘real-life’ conditions. The study cohort consisted of patients from a large, retrospective German multicentre, observational study who had been treated with peginterferon alfa-2a plus RBV or peginterferon alfa-2b plus RBV between the years 2000 and 2007. To ensure comparability regarding peginterferon therapies, patients were analysed in pairs matched by several baseline variables. Univariate and multivariate logistic regression analyses were used to determine the effect of nonmatched baseline variables and treatment modality on SVR. Among 2378 patients (1189 matched pairs), SVR rates were 57.9% overall, 46.5% in HCV genotype 1/4-infected patients and 77.3% in genotype 2/3-infected patients. In multivariate logistic regression analysis, positive predictors of SVR were HCV genotype 2 infection, HCV genotype 3 infection, low baseline viral load and treatment with peginterferon alfa-2a. Negative predictors of SVR were higher age (≥40 years), elevated baseline gamma-glutamyl transpeptidase (GGT) and low baseline platelet count (<150 000/μL). Among patients treated with peginterferon plus RBV in routine clinical practice, genotype, baseline viral load, age, GGT level and platelet levels all predict the likelihood of treatment success. In patients matched by baseline characteristics, treatment with peginterferon alfa-2a may be a positive predictor of SVR when compared to peginterferon alfa-2b.

Keywords: chronic hepatitis C; clinical practice; peginterferon; predictors; sustained virological response

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