Predictive baseline criteria of primary therapeutic failure in chronic hepatitis C genotype 1.
OBJECTIVE
more than half of patients with genotype 1 chronic hepatitis C (CHC) do not achieve a sustained viral response (SVR) to current antiviral therapy due to primary non-response, relapse or intolerance. Factors related to each of these unfavorable outcomes are different and the last two may be partially prevented. Our aim was to identify basal criteria to predict the risk of primary failure.


METHODS
we included 251 consecutive patients (152 males) from a single centre, infected with HCV genotype 1 and not previously treated. SVR was achieved in 141 patients and primary failure in 110.


RESULTS
high vs. low viral load (> 400,000 IU/mL, OR = 6.17; 95% CI: 2.50-15.23), high serum GGT (> 60 IU/mL, OR = 4.25; 95% CI: 2.49-7.24), low serum cholesterol ( < 178 mg/dL, OR = 2.93; 95% CI: 1.75-4.92) and older age (> 47 yrs., OR = 1.79; 95% CI: 1.08-2.96) were associated to the risk of primary failure in the lineal logistic regression analysis. From the 58 patients carrying all the first three negative criteria, 46 (79.3%) were primary non-responders.


CONCLUSIONS
the negative basal profile identified in this study is based on easily available data and provides information about the risk of primary therapeutic failure, and may help to decide whether antiviral therapy should be offered to a single patient.
Cuenca
F
F
Department of Gastroenterology, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Spain.
Fernández
C
C
Devesa
M J
MJ
López-Alonso
G
G
Mayol
J
J
Suárez
A
A
Ortega
L
L
Díaz-Rubio
M
M
Ladero
J M
JM
D000328:Adult; D001706:Biopsy; D002784:Cholesterol / Q000097:blood; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000473:pathology / Q000628:therapy* / Q000821:virology*; D006801:Humans; D008099:Liver / Q000473:pathology / Q000821:virology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000032:analysis / Q000235:genetics; D017211:Treatment Failure
D012367:RNA, Viral; D002784:Cholesterol