[Experiences with the treatment of chronic hepatitis C and prognostic factors for its efficacy in clinical practice].
OBJECTIVE
The study aimed at evaluating antiviral therapy and the impact of selected factors on its efficacy in patients with chronic hepatitis C treated at the Department of Infectology and Travel Medicine in Kosice, Slovakia, between 2003 and 2007.


METHODS
A retrospective analysis of a group of 213 patients treated for chronic hepatitis C and of prognostic factors for treatment efficacy in a subgroup of 159 patients who completed therapy with pegylated interferon alpha and ribavirin.


RESULTS
From the entire group, 193 patients were treated with a combination of pegylated interferon and ribavirin, 5 received pegylated interferon monotherapy and in 15 cases, conventional interferon was used. A total of 179 patients (84 %) were treated for the first time, the remaining 34 patients were treated repeatedly. Genotype 1 was detected in 91.5 % of 189 studied patients. Liver biopsy was performed in 143 patients, with mild, moderate and severe histological changes or liver cirrhosis being detected in 46.9 %, 38.5 % and 14.7 % of them, respectively. In 12.2 % of cases, treatment was discontinued due to adverse effects. In the group of 159 patients who completed therapy, sustained viral response (SVR) was found in 35.8 %; another 12.6 % had viral response at the end of therapy (SVR has not been assessed as yet). Viral relapse or breakthrough were observed in 26.4 % and 25.2 % showed no response. Patients who achieved SVR were more frequently infected with genotypes 2 and 3, had lower degrees of liver fibrosis, lower mean age and more frequently achieved complete early viral response. By contrast, the group of non-responders was characterized by a higher proportion of patients with reduced therapy below 80 %. The other observed differences such as male/female ratio, weight, proportion of patients with normal ALT activity or proportion of previously untreated patients were not significant.


CONCLUSIONS
The efficacy of treatment in our group adjusted for the adverse proportion of genotypes and proportion of patients with repeated therapy was comparable with the literature data. The favorable prognostic factors observed in the group included infection with genotypes 2 or 3, lower degree of liver fibrosis and lower age.
Kristian
Pavol
P
Clinic of Infectology and Travel Medicine, L. Pasteur University Hospital Kosice, Kosice, Slovak Republic. kristian@fnlp.sk
Schréter
Ivan
I
Paralicová
Zuzana
Z
Jarcuska
Pavol
P
Pellová
Alzbeta
A
Magyar
Bartolomej
B
Virág
Ladislav
L
D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D011379:Prognosis
D000998:Antiviral Agents