Hepatitis C treatment outcomes in Australian clinics
| Autor: | Matthew Law, Joe Sasadeusz, George Ostapowicz, Paul A W Haber, Janaki Amin, Gregory J. Dore, Jacob George, Graeme A. Macdonald, Heather F. Gidding, Martin Weltman |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male medicine.medical_specialty Cirrhosis HIV Infections Hepacivirus Interferon alpha-2 Antiviral Agents Body Mass Index Polyethylene Glycols chemistry.chemical_compound Liver disease Pegylated interferon Internal medicine Ribavirin medicine Humans Prospective Studies Intention-to-treat analysis Coinfection business.industry Australia Interferon-alpha virus diseases General Medicine Hepatitis C Odds ratio Hepatitis C Chronic Middle Aged medicine.disease Recombinant Proteins digestive system diseases Clinical trial Logistic Models Treatment Outcome chemistry Multivariate Analysis Drug Therapy Combination Female business Follow-Up Studies medicine.drug |
| Zdroj: | Medical Journal of Australia. 196:633-637 |
| ISSN: | 1326-5377 0025-729X |
| DOI: | 10.5694/mja12.10014 |
| Popis: | OBJECTIVE To determine hepatitis C (HCV) treatment effectiveness and predictors of response in the "real-world" Australian clinic setting. DESIGN, SETTING AND PARTICIPANTS Patients with chronic HCV, who were HCV-treatment-naive at enrolment, and were then treated with standard therapy (pegylated interferon-α plus ribavirin), were recruited prospectively through a national network of 24 HCV clinics between April 2008 and December 2009. Patients were interviewed and a medical record review was conducted at enrolment and at routine follow-up clinic visits. MAIN OUTCOME MEASURES Proportion of patients achieving a sustained virological response (SVR), predictors of SVR, and impact of treatment on biochemical markers of liver disease (alanine aminotransferase levels and aspartate aminotransferase-to-platelet ratio index scores). RESULTS The SVR by intention to treat was 60% (327/550). Infection with HCV genotype 2 or 3 (compared with genotype 1) was an independent predictor of SVR (odds ratio [OR], 2.45; 95% CI, 1.70-3.52), while HIV coinfection (OR, 0.28; 95% CI, 0.10-0.82), cirrhosis (OR, 0.38; 95% CI, 0.18-0.81), and increased body mass index for ≥ 30 kg/m(2) v ≤ 25 kg/m(2) (OR, 0.58; 95% CI, 0.35-0.96) were independently associated with lower SVR. There was a significant improvement in biochemical markers of liver disease following SVR (P< 0.001). CONCLUSIONS Our findings are similar to those seen in clinical trials, despite the inclusion of patients with a broad range of comorbid conditions such as injecting drug and alcohol use and psychiatric illness. They suggest that, with appropriate patient and infrastructure support, expansion of treatment services to the broader HCV-infected community is warranted. |
| Databáze: | OpenAIRE |
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