Retrospective, observational, multicentre study on an Italian population affected by chronic hepatitis C who failed to clear HCV-RNA after the combined therapy (PEG-IFN and ribavirin): NADIR study
| Autor: | Morisco, F, Stroffolini, T, Medda, E, Amoruso, Dc, Almasio, Pl, Villa, E, Zuin, M, Paris, B, Stanzione, M, Caporaso, N, NADIR Study Group, Aceti, A, Amaddeo, G, Ancarani, F, Arcuri, P, Attili, A, Bandiera, F, Bellati, G, Benigno, R, Benini, F, Bombardieri, G, Bruno, S, Capretti, A, Carrara, M, Cottone, C, Cozzolongo, R, Demelia, L, Di Gaetano, G, Esposito, P, Fanelli, G, Gaeta, Gb, Giannini, Eg, Giorgini, A, Grieco, A, Guadagnino, V, Lanzini, A, Lo Bello, S, Lupo, S, Maracci, M, Marchi, S, Martines, D, Mazzella, G, Miele, L, Milan, M, Milani, S, Minoli, G, Montalto, G, Morrone, A, Nosotti, L, Paroli, M, Pastore, G, Persico, Marcello, Piccinino, F, Pinzello, Gb, Pozzi, M, Roffi, L, Russello, M, Russo, M, Sagnelli, E, Savarino, V, Soccorsi, F, Squadrito, G, Tabone, M, Tarsetti, F, Tesini, Em, Testa, R, Tripi, S, Gianfranca, S, Vandelli, C, Zignego, A. L. |
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| Přispěvatelé: | Morisco, F., Stroffolini, T., Medda, E., Amoruso, D. C., Almasio, P. L., Villa, E., Zuin, M., Paris, B., Stanzione, M., Caporaso, N., Nadir Study Group, Mazzella, Giuseppe, Morisco, F, Stroffolini, T, Medda, E, Amoruso, DC, Almasio, PL, Villa, E, Zuin, M, Paris, B, Stanzione, M, Caporaso, N, Montalto, G, Morisco, Filomena, T., Stroffolini, E., Medda, D. C., Amoruso, P. L., Almasio, E., Villa, M., Zuin, B., Pari, M., Stanzione, Caporaso, Nicola |
| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Adult
Male non-responders relapser Genotype body mass index cirrhosis hepatitis c virus nonresponder pegylated-interferon Infectious Disease Hepacivirus virus Interferon alpha-2 Antiviral Agents Polyethylene Glycol Polyethylene Glycols Medication Adherence hepatitis C Risk Factors Retrospective Studie Virology Ribavirin Humans Age Factor Treatment Failure Retrospective Studies Aged Antiviral Agent Settore MED/12 - Gastroenterologia HCV Antiviral therapy Body mass index Cirrhosis Hepatitis C virus Nonresponder Pegylated-interferon Relapser Cirrhosi Hepaciviru Hepatology Risk Factor Age Factors Interferon-alpha Hepatitis C Chronic Middle Aged Recombinant Protein Recombinant Proteins Italy RNA Viral Female Hepatitis C viru Human |
| Popis: | There is a lack of information on the characteristics of patients with chronic hepatitis C virus infection (HCV) who fail to respond to antiviral treatment. We studied HCV-positive subjects with chronic liver diseases treated with pegylated-interferon (PEG-IFN) and ribavirin (RBV) who failed to clear HCV in routine clinical practice. A total of 2150 consecutive adult patients treated with PEG-IFN plus RBV therapy in 46 Italian centres between 1 July 2004, and 30 June 2005, were studied. Of the 2150 patients, 923 (42.9%) (M/F 585/335, mean age 54.8 years) failed to achieve a serum HCV-RNA clearance. Of these 923 patients, 429 (46.5%) were nonresponders, 298 (32.3%) relapsers, 168 (18.2%) drop-outs for noncompliance or adverse events and 28 (3.0%) were lost during follow-up. Overall, 642 (70.6%) patients received adequate therapy (defined as more than 80% of the drug doses for >80% of the time). Genotypes 1-4 were observed in 76.9% of cases; genotypes 2-3 in 21.2% and mixed in 1.9%, respectively. Multiple logistic regression analysis identified genotypes 1 and 4 as the sole independent predictors of the likelihood of nonresponse to therapy compared with relapse (OR: 4.38; 95% CI = 2.28-8.4). Age older than 65 years was the sole independent factor associated with no adherence to therapy (OR: 2.22; 95% CI = 1.36-3.62). Patients who fail to respond to treatment are a nonhomogeneous population with different features, and the sole factor that discriminates nonresponse from relapse is the distribution of genotypes 1-4. Co-morbidities are unable to determine the type of treatment failure and inadequate adherence to therapy mostly affects patients older than 65 years of age. © 2009 Blackwell Publishing Ltd. |
| Databáze: | OpenAIRE |
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