Treatment and retreatment in patients with chronic hepatitis C: 10 years clinical practice in a single centre.
OBJECTIVE
Therapy for chronic hepatitis C (HCV) has mainly been evaluated in large clinical, select population, trials. We sought to evaluate whether prognostic factors of therapeutic response are similar in clinical practice, where treated population is more diverse.


METHODS
Retrospective study of HCV-infected patients who completed >6 months of treatment/retreatment with various therapeutic regimens, in a single reference centre over a 10-year period. Adjuvant treatment with hemopoetic growth factors was used when warranted by treatment side effects.


RESULTS
Overall, 77/125 patients (61.6%) achieved sustained virological response (SVR). Fifty-four naïve patients (43.2%) achieved SVR; 19 (26%) with interferon-alpha (IFN-alpha), 13 (59.1%) with IFN-alpha and ribavirin, and 22 (73.3%) with pegylated IFN-alpha and ribavirin. Seventeen patients responded after two courses of therapy and six after more than three courses, achieving a total SVR of 32%. Patients with genotype-1 were less probable to achieve SVR [odds ratio (OR)=6.23], while younger patients were more possible to achieve SVR, OR=0.97. Most non-responders after >2 regimens were genotype-1 patients (90%).


CONCLUSIONS
In clinical practice, where strict selection criteria cannot be applied, genotype-1 remains the most significant prognostic factor of response failure. Addition of adjuvant hemopoetic growth factors, when warranted, may increase compliance and thus overall SVR.
Economou
Michael S
MS
1st Department of Internal Medicine and Hepato-Gastroenterology Unit, School of Medicine, University of Ioannina, Ioannina, Greece. meconom@cc.uoi.gr
Filis
Spyridon
S
Vienna
Helen
H
Christodoulou
Dimitrios
D
Christou
Leonidas
L
Tsianos
Epameinondas V
EV
D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use; D011994:Recombinant Proteins; D019233:Retreatment; D012254:Ribavirin / Q000009:adverse effects / Q000627:therapeutic use
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C100416:peginterferon alfa-2a