[ROC curve analysis of factors predictive of non-response to interferon treatment in patients with chronic hepatitis C, genotype 1].
The objectives of this study included: 1) to identify pretreatment variables predictive of absence of response in 107 patients with chronic hepatitis C, genotype 1, treated with interferon-a (IFN-a) at a dose of 3 MU three times weekly for 3-12 months and classified into two groups: group A, nonresponders vs. patients with a complete response, and group B, nonresponding and relapsing patients vs. patients with a sustained response; and 2) to establish a prognostic index using ROC curve analysis. The rate of sustained response was 6. 5&#37; at the 24-month follow-up. The pretreatment characteristics with predictive value using ROC curves were as follows: in group A, age, GGT, serum ferritin, viral load, and grade and stage of the histological lesion; and in group B, known duration of infection, GPT, GGT, serum ferritin, viral load, and grade and stage of the histological lesion. In both group A and group B the positive predictive value (the probability of predicting an absence of response when the variable is present) was greater than the negative predictive value (mean: 84.3% vs. 41.1%, 99% vs. 16.5%, respectively). In group A, based on the prognostic index, the positive predictive value when three variables were present was 96&#37; and the sensitivity was 63.5&#37;, with the test being unequivocal in 6.5&#37;, whereas when four or five variables were present, the positive predictive value was 97&#37; and 100&#37; and the sensitivity was 40.5&#37; and 18&#37;, respectively. In group B, the positive predictive value when two variables were present was 100&#37; and the sensitivity was 87&#37;, whereas when three, four, five and six variables were present the sensitivity was between 73&#37; and 28&#37;. In group A, age, GGT and ferritin were the predictive variables independently associated with an absence of response, with a relative risk of 6.5, 4.8 and 3.1, respectively, whereas in group B we did not find variables independently associated with an absence of response. It was concluded that in patients with genotype 1, it is possible to predict the absence of response to IFN therapy with a high degree of reliability.
Olaso
V
V
Servicios de Medicina Digestiva, Hospital Universitario La Fe, Avda. Campanar 21, 46009 Valencia,
Córdoba
J
J
Siles
M S
MS
Molina
J M
JM
Esteban
R J
RJ
Garijo
R
R
Mora
J
J
Nicolás
D
D
Gobernado
M
M
Berenguer
J
J
Segovia
M
M
D000293:Adolescent; D000328:Adult; D005260:Female; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D017211:Treatment Failure
D016898:Interferon-alpha
Análisis mediante curvas ROC de los factores predictivos de no respuestaal tratamiento con interferón en pacientescon hepatitis crónica C genotipo 1.