Predictive value of complete and partial early virological response on sustained virological response rates of genotype-4 chronic hepatitis C patients treated with PEG-interferon plus ribavirin.
OBJECTIVE
To investigate early viral kinetics, sustained virological response (SVR) rates and their predictors, in treatment-naïve, genotype-4-infected, chronic hepatitis C (CHC) patients treated with PEG-IFNalpha2b plus ribavirin.


METHODS
In total, 58 patients were retrospectively analyzed. Early virological response (EVR) was defined as undetectable HCV-RNA (<50 IU/ml) at week 12 (complete, cEVR) or at least a 2 log decrease in HCV-RNA levels (partial, pEVR).


RESULTS
Thirty-one patients exhibited SVR (53.4%), 17 (29.3%) were non-responders and 10 (17.2%) relapsed. Thirty-seven patients (63.8%) exhibited EVR. The positive predictive values of EVR, cEVR and pEVR for the SVR achievement were 83.87, 54.83, and 29.03%, whereas their negative predictive values were 59.25, 77.77, and 81.48%, respectively. Both cEVR (OR 0.040, p = 0.042) and EVR (OR 0.016, p = 0.006) independently predicted SVR. Baseline viral load (p < 0.001), age (p = 0.035) and stage of liver disease (p = 0.04) were significantly related to the EVR achievement, whereas only baseline viral load (p = 0.003) and ethnicity (p = 0.025) predicted cEVR.


CONCLUSIONS
Partial or complete EVR represent independent predictors of SVR in genotype-4-infected CHC patients, regardless of their baseline parameters. The absence of pEVR, rather than the absence of cEVR, should be used as an early indication for discontinuation of treatment in these patients.
Elefsiniotis
I S
IS
University Department of Internal Medicine, Hepatology Unit, Elena Venizelou Hospital, Athens, Greece. ielefs@nurs.uoa.gr
Vezali
E
E
Mihas
C
C
Saroglou
G
G
D000328:Adult; D000818:Animals; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000097:blood; D051381:Rats; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b