Sustained virological response according to the type of early virological response in HCV and HCV/HIV

Ann Hepatol. Apr-Jun 2010;9(2):150-5.

Abstract

Background: The most important factors to predict the sustained virological response (SVR) are the genotype and the fibrosis grade, although there are other predictive factors to be considered, mainly in HCV/HIV coinfected patients.

Aim: To evaluate different prognostic factors to obtain the SVR in HCV monoinfected and HCV/HIV coinfected genotype 1 patients emphasizing the type of early virological response (EVR)-complete or partial.

Methods: This is a cohort study, retrospective, where the registers of HCV monoinfected or HCV/HIV coinfected patients, genotype 1, treated with pegylated interferon + ribavirin were reviewed. The prognostic factors: age greater than 40 years, viral load higher than 600,000UI/mL, and fibrosis grade (score METAVIR) were evaluated pre-treatment, and also the EVR considering the reduction of 100 times of the basal viral load (partial EVR) or negative PCR (complete EVR) in the week 12. In the statistical analysis, multivariate analysis was used. The significance level adopted was 5%.

Results: There were 323 HCV monoinfected and 59 HCV/HIV coinfected. The SVR was 35.3% in monoinfected and 23% in coinfected patients. The worst results was observed in those with age greater than 40 years, high viral load, pronounced fibrosis (F4) and partial EVR, with an expected probability of 1.9% for SVR in those coinfected and 3.8% in monoinfected. In conclusion, patients with cirrhosis HCV genotype 1, age greater than 40 years, high viral load, coinfected with HIV or not, will present a low SVR if did not obtain negative PCR in week 12, and should be evaluated for discontinuation.

MeSH terms

  • Adult
  • Antiviral Agents / therapeutic use*
  • Brazil
  • Chi-Square Distribution
  • Drug Therapy, Combination
  • Female
  • Genotype
  • HIV Infections / complications*
  • Hepacivirus / drug effects*
  • Hepacivirus / genetics
  • Hepacivirus / growth & development
  • Hepatitis C / complications
  • Hepatitis C / diagnosis
  • Hepatitis C / drug therapy*
  • Humans
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use*
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / drug therapy
  • Liver Cirrhosis / virology
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Polyethylene Glycols / therapeutic use*
  • Recombinant Proteins
  • Registries
  • Retrospective Studies
  • Ribavirin / therapeutic use*
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Viral Load*

Substances

  • Antiviral Agents
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • peginterferon alfa-2b
  • peginterferon alfa-2a