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Multicenter Study
. 2014 Sep;46(9):818-25.
doi: 10.1016/j.dld.2014.05.015. Epub 2014 Jun 20.

An a Priori Prediction Model of Response to Peginterferon Plus Ribavirin Dual Therapy in Naïve Patients With Genotype 1 Chronic Hepatitis C

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Multicenter Study

An a Priori Prediction Model of Response to Peginterferon Plus Ribavirin Dual Therapy in Naïve Patients With Genotype 1 Chronic Hepatitis C

Angelo Andriulli et al. Dig Liver Dis. .

Abstract

Background: Aim was to select naïve patients with genotype 1 chronic hepatitis C having a high probability of response to Peg-interferon+ribavirin therapy.

Methods: In 1073 patients (derivation cohort), predictors of rapid and sustained virological response were identified by logistic analysis; regression coefficients were used to generate prediction models for sustained virological response. Probabilities at baseline and treatment week 4 were utilized to develop a decision rule to select patients with high likelihood of response. The model was then validated in 423 patients (validation cohort).

Results: In the derivation cohort, 257 achieved rapid virological response and 818 did not, with sustained virological response rates of 80.2% and 25.4%, respectively; interleukin-28B polymorphisms, fibrosis staging, gamma-glutamyl transferase, and viral load predicted sustained virological response. Assuming a <30% sustained virological response probability for not recommending Peg-interferon+ribavirin, 100 patients (25.6%) in the validation cohort were predicted a priori to fail this regimen. Assuming a ≥80% sustained virological response probability as a threshold to continue with Peg-interferon+ribavirin, 61 patients were predicted to obtain sustained virological response, and 55 of them (90.2%) eventually did.

Conclusions: This model uses easily determined variables for a personalized estimate of the probability of sustained virological response with Peg-interferon+ribavirin, allowing to identify patients who may benefit from conventional therapy.

Keywords: Chronic hepatitis; HCV infection; Peg-interferon and ribavirin treatment; Predictors of sustained virological response, Rapid virological response.

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