title: Predictive factors for sustained virological response after treatment with pegylated interferon α-2a and ribavirin in patients infected with HCV genotypes 2 and 3.
abstract: BACKGROUND
  Previous trials have often defined genotype 2 and 3 patients as an "easy to treat" group and guidelines recommend similar management.
  
  
  OBJECTIVE
  The present study looks for differences between the two genotypes and analyzes predictive factors for SVR.
  
  
  METHODS
  Prospective, community-based cohort study involving 421 physicians throughout Germany. The analysis includes 2,347 patients with untreated chronic HCV genotype 2 (n = 391) and 3 (n = 1,956) infection treated with PEG-IFN α-2a plus ribavirin between August 2007 and July 2012.
  
  
  RESULTS
  When compared with genotype 2 patients, those with genotype 3 were younger, had a shorter duration of infection, lower values of total cholesterol, LDL cholesterol and BMI, a higher frequency of drug use as infection mode and male gender (p<0.0001, respectively), and a higher APRI score (p<0.005). SVR was higher in genotype 2 when compared with genotype 3 (64.7% vs. 56.9%, p = 0.004). By multivariate analysis of genotype 2 patients, low baseline γ -GT and RVR predicted SVR. In genotype 3 age ≤45 years, cholesterol>130 mg/dl, a low APRI score, and a γ-GT ≥3-times ULN, RVR, and RBV starting dose were associated with SVR by multivariate analysis.
  
  
  CONCLUSIONS
  The present study corroborates that liver fibrosis is more pronounced in genotype 3 vs. 2. SVR is higher in genotype 2 versus genotype 3 partly because of follow-up problems in genotype 3 patients, in particular in those infected by drug use. Thus, subgroups of genotype 3 patients have adherence problems and need special attention also because they often have significant liver fibrosis.
  
  
  BACKGROUND
  Verband Forschender Arzneimittelhersteller e.V., Berlin, Germany ML21645 ClinicalTrials.gov NCT02106156.
authors.affiliation: Clinic for Internal Medicine, St. Josef Hospital, Oberhausen, Germany.
authors.forename: Claus
authors.initials: C
authors.lastname: Niederau
authors.affiliation: Center for HIV and Hepatogastroenterology, Duesseldorf, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Mauss
authors.affiliation: Center of Gastroenterology, Goettingen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schober
authors.affiliation: ifi-Institute for Interdisciplinary Medicine, Hamburg, Germany.
authors.forename: Albrecht
authors.initials: A
authors.lastname: Stoehr
authors.affiliation: 1st Medical Clinic, Dept. Gastroenterology and Hepatology, Johannes Gutenberg University of Mainz, Mainz, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Zimmermann
authors.affiliation: Medcenter Leipzig, Leipzig, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Waizmann
authors.affiliation: Center of Gastroenterology, Kassel, Germany.
authors.forename: Gero
authors.initials: G
authors.lastname: Moog
authors.affiliation: Center of Gastroenterology, Paderborn, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Pape
authors.affiliation: Competence Center for Addiction, Praxiszentrum Friedrichsplatz, Kassel, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Weber
authors.affiliation: Practice for general medicine, Koeln, Germany.
authors.forename: Konrad
authors.initials: K
authors.lastname: Isernhagen
authors.affiliation: General Practice, Berlin, Germany.
authors.forename: Petra
authors.initials: P
authors.lastname: Sandow
authors.affiliation: Gastroenterology Practice, Minden, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Bokemeyer
authors.affiliation: Virology, Roche Pharma AG, Grenzach-Wyhlen, Germany.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Alshuth
authors.affiliation: Practice for internal Medicine, Berlin, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Steffens
authors.affiliation: Center of Gastroenterology, Herne, Germany.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Hüppe
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D005838:Genotype; D005858:Germany; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology*; D006526:Hepatitis C / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged