Sustained virologic response to peginterferon α-2a and ribavirin in 335 patients with chronic hepatitis C: A tertiary care center experience

Autor: Al Ashgar Hamad, Khan Mohammed, Helmy Ahmed, Al Swat Khalid, Al Shehri Abdullah, Al Kalbani Abdalla, Peedikayel Musthafa, Al Kahtani Khalid, Al Quaiz Mohammed, Rezeig Mohammed, Kagevi Ingvar, Al Fadda Mohammed
Jazyk: angličtina
Rok vydání: 2008
Předmět:
Zdroj: The Saudi Journal of Gastroenterology, Vol 14, Iss 2, Pp 58-65 (2008)
Druh dokumentu: article
ISSN: 1319-3767
1998-4049
Popis: Background/Aim: This retrospective study assessed the efficacy, safety, and the predictors of sustained viral response (SVR) to a 48-week-course of peginterferon α-2a (Pegasys) and ribavirin combination therapy in 335 consecutive Saudi patients with chronic hepatitis C virus (HCV) infection. Materials and Methods: Clinical, biochemical, and virological parameters were collected at time 0 (pretreatment) and at 12, 24, 48, and 72 weeks posttreatment. The mean ± SD age was 49.1 ± 13.0 years; 229 (68.4%) were males, mean ± SD body mass index was 27.8 ± 7.4, 85 (25.4%) were diabetic, 25 (7.5%) had renal impairment, 136 (40.6%) had previously received interferon ± ribavirin therapy, and 247 (73.7%) underwent pretreatment liver biopsy. Patients with genotypes 1, 2 or 3, 4 and mixed genotype were 60 (22.15%), 30 (11.0%), 148 (54.4%), and 34 (12.5%), respectively. Results: Early viral response (≥2-log10 HCV-RNA decline 12 weeks posttreatment) was achieved in 253 (75.3%). Patients who completed 48 weeks of treatment were 292 (87.1%); of these, 121 (75.6%) achieved ETVR, 161 (55.1%) continued to have SVR and 60 (20.5%) had a viral relapse following end-of-treatment response, that is 48.1 and 17.9% of all patients (n = 335), respectively. Nonresponders (NR) were 71 (24.3%) patients and 43 (12.8%) were unable to complete treatment (due to side effects or loss to follow up). Compared to the relapsers, patients with SVR were significantly younger ( P = 0.000), nondiabetics ( P = 0.015), had higher serum albumin ( P = 0.007), had less pretreatment inflammatory grade ( P = 0.011), infected with genotypes 2 or 3 ( P = 0.014), and treatment-naοve patients ( P = 0.001). However, in stepwise multivariate logistic regression analysis, only treatment naivetι and low pretreatment inflammatory score were the independent predictors of SVR ( P = 0.005 and P = 0.018, respectively). Conclusion: Combination therapy, if tolerated and completed, is effective in treating chronic HCV patients, especially those with no previous interferon therapy and lower pretreatment inflammatory grade.
Databáze: Directory of Open Access Journals
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