Early identification of HCV genotype 1 patients responding to 24 weeks
peginterferon alpha-2a (40 kd)/ribavirin therapy.
 a.. Jensen DM,
 b.. Morgan TR,
 c.. Marcellin P,
 d.. Pockros PJ,
 e.. Reddy KR,
 f.. Hadziyannis SJ,
 g.. Ferenci P,
 h.. Ackrill AM,
 i.. Willems B.
Center for Liver Diseasees, University of Chicago Hospitals, 60637, USA.
djensen@medicine.bsd.uchicago.edu

Approximately one third of hepatitis C virus (HCV) genotype 1 patients
achieved a sustained virological response (SVR) after 24 weeks of treatment
with peginterferon alpha-2a (40 kd) plus ribavirin in a randomized,
multinational trial. We aimed to identify factors associated with a rapid
virological response (RVR) at week 4 (HCV RNA <50 IU/mL) and a SVR (HCV RNA
<50 IU/mL at the end of follow-up) in these patients. Stepwise multiple
logistic regression analysis was used to explore the prognostic factors for
a RVR and SVR in genotype 1 patients treated for 24 weeks. Fifty-one of 216
(24%) genotype 1 patients in the 24-week treatment groups had a RVR. SVR
rates were considerably higher in patients with than without [corrected] a
RVR (89% vs. 19%, respectively). Patients with a baseline HCV RNA of less
than 200,000 IU/mL (OR 9.7, 95% CI 4.2-22.5; P < .0001) or 200,000-600,000
IU/mL (OR 5.6, 95% CI 1.5-9.1; P = .0057) were more likely to achieve a RVR
than those with HCV RNA greater than 600,000 IU/mL. HCV subtype (1b vs. 1a)
was also independently associated with RVR (OR 1.8, 95% CI 0.9-3.7; P =
.0954). RVR (OR 23.7 vs. no RVR, 95% CI 9.1-61.7) and baseline HCV RNA less
than 200,000 IU/mL (OR 2.7 vs. > 600,000 IU/mL, 95% CI 1.1-6.3; P < .026)
were significant and independent predictors of SVR in patients treated for
24 weeks. In conclusion, patients infected with HCV genotype 1 and treated
with peginterferon alpha-2a/ribavirin sustained a RVR 24% of the time. This
portends an 89% probability of a SVR after 24 weeks of treatment.

PMID: 16628671 [PubMed - indexed for MEDLINE]