Assessment of baseline pretreatment factors and on‐treatment virological response to predict sustained virological response in patients with chronic hepatitis C treated with pegylated interferon and ribavirin

Abstract

SummaryBackgroundsPegalated interferon (PEG‐IFN) combination with ribavirin (RBV) (PR) in accordance to response‐guide therapy (RGT) is a treatment option for chronic hepatitis C (CHC) in the past decade. Baseline host and viral factors and early viral kinetics are important determinants for patient using combination therapy.AimsWe aimed to investigate the effects of host and viral factors on sustained virus response (SVR). We researched the possible predictors of an SVR.MethodsWe retrospectively analyzed a total of 158 CHC patients who had been treated with a PR dual therapy. Clinical parameters and virological responses were analyzed for their relationship with SVR.ResultsThe overall SVR rate was 71.5% (113/158). Factors associated with an SVR were ALT levels > 3xULN, non‐AST/ALT > 1, non‐genotype 1 and non‐cirrhosis. Non‐genotype 1 (OR: 3.154; 95% CI: 1.309‐7.601; P = 0.010), and non‐cirrhosis (OR: 2.696; 95% CI: 1.045‐6.956; P = 0.004) were the predictors of an SVR. An SVR significantly increased in patients with an RVR and significantly reduced in patients with cEVR, pEVR, null response and relapse. In addition, an RVR was a powerful independent predictor of an SVR (OR: 38.263; 95% CI: 10.184‐143.757; P = 0.000). The positive predictive value (PPV) of an RVR on SVR was 92.2% (94/102).ConclusionsNon‐cirrhosis, non‐genotype 1 and achievement of an RVR are independent predictors of SVR. A 4 week RVR is the best predictor of an SVR in CHC patients with a PR dual treatment. An RVR predicts treatment success early.Copyright © 2016, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.