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Factors Predicting Response to Therapy for Chronic Hepatitis C

The evidence for the effectiveness of current established treatment guidelines for chronic hepatitis C virus (HCV) infection is derived from multinational randomized controlled trials. Strategies for managing HCV, however, require an assessment of the effectiveness of interventions in routine clinical practice.

Researchers in the U.K. evaluated the outcomes of combination interferon-based therapy in a large cohort of chronic hepatitis C patients. The results of this retrospective study appear in the April 2008 Journal of Viral Hepatitis.

Results

• A total of 347 patients (113 with HCV genotype 1, 234 with non-1 genotypes) were treated with pegylated interferon plus ribavirin according to current guidelines.

• 42 patients (37.2%) with genotype 1 and 164 subjects (70.1%) with non-1 genotypes achieved sustained viral response (SVR).

• 39 patients (11%) withdrew from treatment prematurely.

• In addition to viral genotype, other factors predictive of a response to therapy were patient age at the start of treatment and disease stage on pretreatment liver biopsy.

• Multivariate regression analysis demonstrated that the effects of age per 10-year increment (P = 0.006) were confined to patients with genotype 1.

• A multivariate logistic model to predict the probability of SVR for subgroups defined by disease stage, genotype, and age at initiation of therapy revealed striking differences in predicted response rates between subgroups.

• The model provided a strong rationale for early treatment, particularly for those with HCV genotype 1.

Conclusion

Based on their findings, the study authors concluded, "Our study demonstrates that results comparable with those of randomized clinical trials can be achieved in clinical practice, and suggests that prediction of response rates based on probability modeling will provide a valuable adjunct to individual patient management."

Department of Microbiology and Infectious Diseases, University of Nottingham, Nottingham, UK; MRC Biostatistics Unit, Institute of Public Health, Cambridge, UK; Nottingham University Hospitals (Queen's Medical Centre Campus), Nottingham, UK; Health Services Research Unit, London School of Hygiene and Tropical Medicine, London, UK.

4/15/08

Reference
BJ Thomson, G Kwong, S Ratib, and others (for the Trent HCV Study Group). Response rates to combination therapy for chronic HCV infection in a clinical setting and derivation of probability tables for individual patient management. Journal of Viral Hepatitis 15(4): 239-321. April 2008.

 

 

 

 

 

 

 

 







 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


FDA-approved Combination Therapies for Chronic HCV Infection

Pegasys + Copegus
PEG-Intron + Rebetol
Intron A + Rebetol
Roferon A + Ribavirin