Predictive factors for sustained virological response after treatment with pegylated interferon α-2a and ribavirin in patients infected with HCV genotypes 2 and 3.

<h4>Background</h4>Previous trials have often defined genotype 2 and 3 patients as an "easy to treat" group and guidelines recommend similar management.<h4>Aims</h4>The present study looks for differences between the two genotypes and analyzes predictive factors for...

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Autores principales:	Claus Niederau, Stefan Mauss, Andreas Schober, Albrecht Stoehr, Tim Zimmermann, Michael Waizmann, Gero Moog, Stefan Pape, Bernd Weber, Konrad Isernhagen, Petra Sandow, Bernd Bokemeyer, Ulrich Alshuth, Hermann Steffens, Dietrich Hüppe
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/7d1f2f83d9d84eda81a49ca51c12a914
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spelling	oai:doaj.org-article:7d1f2f83d9d84eda81a49ca51c12a9142021-11-25T05:59:58ZPredictive factors for sustained virological response after treatment with pegylated interferon α-2a and ribavirin in patients infected with HCV genotypes 2 and 3.1932-620310.1371/journal.pone.0107592https://doaj.org/article/7d1f2f83d9d84eda81a49ca51c12a9142014-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0107592https://doaj.org/toc/1932-6203<h4>Background</h4>Previous trials have often defined genotype 2 and 3 patients as an "easy to treat" group and guidelines recommend similar management.<h4>Aims</h4>The present study looks for differences between the two genotypes and analyzes predictive factors for SVR.<h4>Methods</h4>Prospective, community-based cohort study involving 421 physicians throughout Germany. The analysis includes 2,347 patients with untreated chronic HCV genotype 2 (n = 391) and 3 (n = 1,956) infection treated with PEG-IFN α-2a plus ribavirin between August 2007 and July 2012.<h4>Results</h4>When compared with genotype 2 patients, those with genotype 3 were younger, had a shorter duration of infection, lower values of total cholesterol, LDL cholesterol and BMI, a higher frequency of drug use as infection mode and male gender (p<0.0001, respectively), and a higher APRI score (p<0.005). SVR was higher in genotype 2 when compared with genotype 3 (64.7% vs. 56.9%, p = 0.004). By multivariate analysis of genotype 2 patients, low baseline γ -GT and RVR predicted SVR. In genotype 3 age ≤45 years, cholesterol>130 mg/dl, a low APRI score, and a γ-GT ≥3-times ULN, RVR, and RBV starting dose were associated with SVR by multivariate analysis.<h4>Conclusions</h4>The present study corroborates that liver fibrosis is more pronounced in genotype 3 vs. 2. SVR is higher in genotype 2 versus genotype 3 partly because of follow-up problems in genotype 3 patients, in particular in those infected by drug use. Thus, subgroups of genotype 3 patients have adherence problems and need special attention also because they often have significant liver fibrosis.<h4>Trial registration</h4>Verband Forschender Arzneimittelhersteller e.V., Berlin, Germany ML21645 ClinicalTrials.gov NCT02106156.Claus NiederauStefan MaussAndreas SchoberAlbrecht StoehrTim ZimmermannMichael WaizmannGero MoogStefan PapeBernd WeberKonrad IsernhagenPetra SandowBernd BokemeyerUlrich AlshuthHermann SteffensDietrich HüppePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 9, p e107592 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Claus Niederau Stefan Mauss Andreas Schober Albrecht Stoehr Tim Zimmermann Michael Waizmann Gero Moog Stefan Pape Bernd Weber Konrad Isernhagen Petra Sandow Bernd Bokemeyer Ulrich Alshuth Hermann Steffens Dietrich Hüppe Predictive factors for sustained virological response after treatment with pegylated interferon α-2a and ribavirin in patients infected with HCV genotypes 2 and 3.
description	<h4>Background</h4>Previous trials have often defined genotype 2 and 3 patients as an "easy to treat" group and guidelines recommend similar management.<h4>Aims</h4>The present study looks for differences between the two genotypes and analyzes predictive factors for SVR.<h4>Methods</h4>Prospective, community-based cohort study involving 421 physicians throughout Germany. The analysis includes 2,347 patients with untreated chronic HCV genotype 2 (n = 391) and 3 (n = 1,956) infection treated with PEG-IFN α-2a plus ribavirin between August 2007 and July 2012.<h4>Results</h4>When compared with genotype 2 patients, those with genotype 3 were younger, had a shorter duration of infection, lower values of total cholesterol, LDL cholesterol and BMI, a higher frequency of drug use as infection mode and male gender (p<0.0001, respectively), and a higher APRI score (p<0.005). SVR was higher in genotype 2 when compared with genotype 3 (64.7% vs. 56.9%, p = 0.004). By multivariate analysis of genotype 2 patients, low baseline γ -GT and RVR predicted SVR. In genotype 3 age ≤45 years, cholesterol>130 mg/dl, a low APRI score, and a γ-GT ≥3-times ULN, RVR, and RBV starting dose were associated with SVR by multivariate analysis.<h4>Conclusions</h4>The present study corroborates that liver fibrosis is more pronounced in genotype 3 vs. 2. SVR is higher in genotype 2 versus genotype 3 partly because of follow-up problems in genotype 3 patients, in particular in those infected by drug use. Thus, subgroups of genotype 3 patients have adherence problems and need special attention also because they often have significant liver fibrosis.<h4>Trial registration</h4>Verband Forschender Arzneimittelhersteller e.V., Berlin, Germany ML21645 ClinicalTrials.gov NCT02106156.
format	article
author	Claus Niederau Stefan Mauss Andreas Schober Albrecht Stoehr Tim Zimmermann Michael Waizmann Gero Moog Stefan Pape Bernd Weber Konrad Isernhagen Petra Sandow Bernd Bokemeyer Ulrich Alshuth Hermann Steffens Dietrich Hüppe
author_facet	Claus Niederau Stefan Mauss Andreas Schober Albrecht Stoehr Tim Zimmermann Michael Waizmann Gero Moog Stefan Pape Bernd Weber Konrad Isernhagen Petra Sandow Bernd Bokemeyer Ulrich Alshuth Hermann Steffens Dietrich Hüppe
author_sort	Claus Niederau
title	Predictive factors for sustained virological response after treatment with pegylated interferon α-2a and ribavirin in patients infected with HCV genotypes 2 and 3.
title_short	Predictive factors for sustained virological response after treatment with pegylated interferon α-2a and ribavirin in patients infected with HCV genotypes 2 and 3.
title_full	Predictive factors for sustained virological response after treatment with pegylated interferon α-2a and ribavirin in patients infected with HCV genotypes 2 and 3.
title_fullStr	Predictive factors for sustained virological response after treatment with pegylated interferon α-2a and ribavirin in patients infected with HCV genotypes 2 and 3.
title_full_unstemmed	Predictive factors for sustained virological response after treatment with pegylated interferon α-2a and ribavirin in patients infected with HCV genotypes 2 and 3.
title_sort	predictive factors for sustained virological response after treatment with pegylated interferon α-2a and ribavirin in patients infected with hcv genotypes 2 and 3.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/7d1f2f83d9d84eda81a49ca51c12a914
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Predictive factors for sustained virological response after treatment with pegylated interferon α-2a and ribavirin in patients infected with HCV genotypes 2 and 3.

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