Identification of Na�ve Hcv-1 Patients with Chronic Hepatitis who may Benefit from Dual Therapy with Peg-Interferon and Ribavirin
The pool of HCV genotype 1 patients likely to be cured by peg-interferon and ribavirin remains to be quantified.
In 1045 patients treated with peg-interferon and ribavirin, two therapeutic strategies were confronted: the first one evaluated only baseline variables associated with sustained virological response (SVR), and the second one included the rapid virologic response (RVR) in addition to baseline predictors. A 80% SVR rate was the threshold to retain a strategy as clinically relevant.
Overall, 414 patients (39.6%) attained SVR. In the first strategy, the hierarchy of features independently associated with SVR were IL28B CC genotype (OR 5.082; CI 3.637-7.101), low (<400.000 iu) viremia (or 2.907; ci 2.111-4.004), f0-f2 fibrosis (or 1.631; ci 1.122-2.372) and type 2 diabetes (or 0.528; ci 0.286-0.972). in the alternative strategy, svr was associated with rvr (or 6.273; ci 4.274�9.208), il28b cc genotype (or 3.306; ci 2.301�4.751), low viremia (or 2.175; ci 1.542-3.070), and f0-f2 fibrosis (or 1.506; ci 1.012-2.242). combining the favorable baseline variables, the rates of svr ranged from 42.4% to 83.3%, but only 66 patients (6.3%, overall) with all predictors could be anticipated to reach the>80% SVR threshold. Only 26.6% of no-RVR patients attained SVR. Among the 255 RVR patients, the likelihood of SVR was 61.8% in those with unfavorable predictors, 80% in the presence of a single predictor, and 100% when both predictors were present. By using this model, 200 patients (19.1%) were predicted to have a 80% chance of being cured with dual therapy.400.000>
A consistent subset of na�ve HCV-1 patients, identified by some baseline characteristics and RVR, may benefit from dual treatment with peg-interferon and ribavirin.