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Aghemo A, Rumi MG, Soffredini R, D'Ambrosio R, Ronchi G, Del Ninno E, Gallus S, Colombo M. Impaired Response to Interferon-α2B plus Ribavirin in Cirrhotic Patients with Genotype 3A Hepatitis C Virus Infection. Antivir Ther 2005. [DOI: 10.1177/135965350601100602] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Patients with chronic infection with the 3a genotype of hepatitis C virus (HCV) are considered as ‘easy-to-treat’ with interferon/ribavirin (IFN/RBV), independent of liver disease severity. However, patients with extensive fibrosis or cirrhosis were under-represented in all the registration Phase III trials performed so far. To assess the influence of liver fibrosis on the outcome of anti-HCV therapy, all patients with genotype 3a hepatitis C who were naive to IFN-based therapies, and received RBV combined with standard IFN or pegylated IFN-α2b (peg-IFN-α2b) as standard of care for their disease, were investigated at our centre. A sustained virological response (SVR) was achieved in 68 of 91 patients (75%) independent of IFN type, pretreatment viraemia, clearance of HCV RNA at week 4 and relevant co-morbidities. A SVR was less common in cirrhotics (6 of 17) than in non-cirrhotics (62 of 74; 35% vs 84%; P<0.0005). Compared to non-cirrhotics, the age and sex adjusted odds ratio (OR) of treatment failure for cirrhotics was 10.1 (95% confidence interval: 2.4–41.7). By multivariate analysis, cirrhosis was the only predictor of non-SVR. In conclusion, cirrhosis is an independent predictor of IFN/RBV treatment failure in patients chronically infected with HCV 3a and is associated with an increased risk of post-treatment hepatitis relapse. Evaluation of liver fibrosis is important in the management of patients with genotype 3a hepatitis C, since it helps to predict response to IFN/RBV therapy.
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Affiliation(s)
- Alessio Aghemo
- A.M. Migliavacca Centre for Liver Disease, Division of Gastroenterology, Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, University of Milan, Milan, Italy
| | - Maria Grazia Rumi
- A.M. Migliavacca Centre for Liver Disease, Division of Gastroenterology, Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, University of Milan, Milan, Italy
| | - Roberta Soffredini
- A.M. Migliavacca Centre for Liver Disease, Division of Gastroenterology, Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, University of Milan, Milan, Italy
| | - Roberta D'Ambrosio
- A.M. Migliavacca Centre for Liver Disease, Division of Gastroenterology, Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, University of Milan, Milan, Italy
| | - Guido Ronchi
- A.M. Migliavacca Centre for Liver Disease, Division of Gastroenterology, Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, University of Milan, Milan, Italy
| | - Ersilio Del Ninno
- A.M. Migliavacca Centre for Liver Disease, Division of Gastroenterology, Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, University of Milan, Milan, Italy
| | - Silvano Gallus
- Istituto di Ricerche Farmacologiche ‘Mario Negri’, Milan, Italy
| | - Massimo Colombo
- A.M. Migliavacca Centre for Liver Disease, Division of Gastroenterology, Fondazione IRCCS Policlinico, Mangiagalli e Regina Elena, University of Milan, Milan, Italy
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