Early identification of HCV genotype 1 patients responding to 24 weeks peginterferon α-2a (40 kd)/ribavirin therapy

被引:387
作者
Jensen, DM
Morgan, TR
Marcellin, P
Pockros, PJ
Reddy, KR
Hadziyannis, SJ
Ferenci, P
Ackrill, AM
Willems, B
机构
[1] Univ Chicago, Ctr Liver Dis, Chicago, IL 60637 USA
[2] VA Med Ctr, Long Beach, CA USA
[3] Hop Beaujon, Clichy, France
[4] Scripps Clin, La Jolla, CA USA
[5] Univ Penn, Philadelphia, PA 19104 USA
[6] Henry Dunant Hosp, Athens, Greece
[7] Med Univ Vienna, Dept Internal Med 4, Vienna, Austria
[8] Roche, Welwyn, Wales
[9] CHU Montreal, Montreal, PQ, Canada
关键词
D O I
10.1002/hep.21159
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Approximately one third of hepatitis C virus (HCV) genotype I patients achieved a sustained virological response (SVR) after 24 weeks of treatment with peginterferon alpha-2a (40 kd) plus ribavirin in a randomized, multinational trial. We aimed to identify factors associated with a rapid virological response (RVR) at week 4 (HCV RNA < 50 IU/mL) and a SVR (HCV RNA < 50 IU/mL at the end of follow-up) in these patients. Stepwise multiple logistic regression analysis was used to explore the prognostic factors for a RVR and SVR in genotype I patients treated for 24 weeks. Fifty-one of 216 (24%) genotype 1 patients in the 24-week treatment groups had a RVR. SVR rates were considerably higher in patients without a RVR (89% vs. 19%, respectively). Patients with a baseline HCV RNA of less than 200,000 IU/mL (OR 9.7, 95% CI 4.2-22.5; P < .0001) or 200,000-600,000 IU/mL (OR 3.6, 95% CI 1.5-9.1; P = .0057) were more likely to achieve a RVR than those with HCV RNA greater than 600,000 IU/mL. HCV subtype (1b vs. 1a) was also independently associated with RVR (OR 1.8, 95% CI 0.9-3.7; P = .0954). RVR (OR 23.7 vs. no RVR, 95% CI 9.1-61.7) and baseline HCV RNA less than 200,000 IU/mL (OR 2.7 vs. > 600,000 IU/mL, 95% CI 1.1-6.3; P < .026) were significant and independent predictors of SVR in patients treated for 24 weeks. In conclusion, patients infected with HCV genotype 1 and treated with peginterferon alpha-2a/ ribavirin sustained a RVR 24% of the time. This portends an 89% probability of a SVR after 24 weeks of treatment.
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页码:954 / 960
页数:7
相关论文
共 8 条
[1]   A 48-week duration of therapy with pegylated interferon α2b plus ribavirin may be too short to maximize long-term response among patients infected with genotype-1 hepatitis C virus [J].
Drusano, GL ;
Preston, SL .
JOURNAL OF INFECTIOUS DISEASES, 2004, 189 (06) :964-970
[2]   Predicting sustained virological responses in chronic hepatitis C patients treated with peginterferon alfa-2a (40 KD)/ribavirin [J].
Ferenci, P ;
Fried, MW ;
Shiffman, ML ;
Smith, CI ;
Marinos, G ;
Gonçales, FL ;
Häussinger, D ;
Diago, M ;
Carosi, G ;
Dhumeaux, D ;
Craxì, A ;
Chaneac, M ;
Reddy, KR .
JOURNAL OF HEPATOLOGY, 2005, 43 (03) :425-433
[3]   Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. [J].
Fried, MW ;
Shiffman, ML ;
Reddy, KR ;
Smith, C ;
Marinos, G ;
Goncales, FL ;
Haussinger, D ;
Diago, M ;
Carosi, G ;
Dhumeaux, D ;
Craxi, A ;
Lin, A ;
Hoffman, J ;
Yu, J .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 347 (13) :975-982
[4]   Peginterferon-α2a and ribavirin combination therapy in chronic hepatitis C -: A randomized study of treatment duration and ribavirin dose [J].
Hadziyannis, SJ ;
Sette, H ;
Morgan, TR ;
Balan, V ;
Diago, M ;
Marcellin, P ;
Ramadori, G ;
Bodenheimer, H ;
Bernstein, D ;
Rizzetto, M ;
Zeuzem, S ;
Pockros, PJ ;
Lin, A ;
Ackrill, AM .
ANNALS OF INTERNAL MEDICINE, 2004, 140 (05) :346-355
[5]   Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial [J].
Manns, MP ;
McHutchison, JG ;
Gordon, SC ;
Rustgi, VK ;
Shiffman, M ;
Reindollar, R ;
Goodman, ZD ;
Koury, K ;
Ling, MH ;
Albrecht, JK .
LANCET, 2001, 358 (9286) :958-965
[6]  
Sanchez-Tapias JM, 2004, HEPATOLOGY, V40, p218A
[7]   Diagnosis, management, and treatment of hepatitis C [J].
Strader, DB ;
Wright, T ;
Thomas, DL ;
Seeff, LB .
HEPATOLOGY, 2004, 39 (04) :1147-1171
[8]   Efficacy of 24 weeks treatment with peginterferon alfa-2b plus ribavirin in patients with chronic hepatitis C infected with genotype 1 and low pretreatment viremia [J].
Zeuzem, S ;
Buti, M ;
Ferenci, P ;
Sperl, J ;
Horsmans, Y ;
Cianciara, J ;
Ibranyi, E ;
Weiland, O ;
Noviello, S ;
Brass, C ;
Albrecht, J .
JOURNAL OF HEPATOLOGY, 2006, 44 (01) :97-103