Ultra-Rapid Virological Response, Young Age, Low γ-GT-ALT-Ratio, and Absence of Steatosis Identify a Subgroup of HCV Genotype 3 Patients Who Achieve SVR with IFN-α2a MonotherapyReportar como inadecuado




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Digestive Diseases and Sciences

, 56:3296

First Online: 13 October 2011Received: 11 July 2011Accepted: 21 September 2011

Abstract

Background and AimsThe standard treatment regimen for chronic HCV genotype 3 HCV-G3 hepatitis consists of PEGylated interferon-α IFN-α and ribavirin at varying doses ranging from 400 to 1,200 mg and results in response rates of 80%. However, this therapy has substantial side-effects including anemia, is teratogenic, and costly. To reduce the side-effects of therapy, the role of monotherapy consisting of only IFN-α was investigated.

MethodsA retrospective analysis of individual therapy courses of HCV-G3-infected patients who were treated with IFN-α2a monotherapy or a combination therapy with attention to the treatment outcome and the presence of IL28B rs12979860 and IL28B rs8099917 single-nucleotide polymorphism genotypes was performed. Conventional prognostic features in each case were assessed as well.

ResultsIn the study, 15-30 50% of patients treated with IFN-α2a monotherapy and 32-36 89% treated with combination therapy achieved a sustained virological response SVR. In addition, 7-11 64% of those treated initially with monotherapy and subsequently with combination therapy achieved an SVR. An -ultra-rapid- virological response occurring within 2 weeks of initiation of therapy p = 0.005, young age <40; p < 0.001 and low initial γ-GT-ALT-ratio p = 0.03 were associated with a SVR to IFN-α2a monotherapy. An SVR in those treated with combination therapy was found to be associated with a rapid virological response RVR p = 0.03. The absence of histologic steatosis was associated with SVR in all patient groups p = 0.01. Therapy duration 24 vs. 48 weeks did not affect the SVR in either group. As expected, combination therapy resulted in more hematological side-effects than did monotherapy.

ConclusionsAn -ultra-rapid- virological response, young age, low initial γ-GT-ALT-ratio and absence of steatosis were each associated with an SVR in those receiving IFN-α2a monotherapy. Therefore, monotherapy in these patients should still be discussed independently of the existence of the IL28B polymorphisms.

KeywordsChronic hepatitis C virus infection Treatment Monotherapy Ribavirin  Download fulltext PDF



Autor: Ahmad Amanzada - Armin Goralczyk - Federico Moriconi - Martina Blaschke - Inga-Marie Schaefer - David van Thiel - Sabine M

Fuente: https://link.springer.com/



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