Rapid Virological Response Represents the Highest Prediction Factor of Response to Antiviral Treatment in HCV-Related Chronic Hepatitis: a Multicenter Retrospective Study.
BACKGROUND
Standard [i.e. pegylated interferon (Peg-IFN) + ribavirin] treatment of hepatitis C virus (HCV)-related chronic hepatitis is associated with a sustained virological response (SVR) in 50 - 90% of patients. A rapid virological response (RVR) (i.e. negative HCV-RNA after 4 weeks of treatment) predicts SVR in almost 90% of patients.


OBJECTIVE
The main aim of this study was to assess the strength of RVR, as a predictive factor of antiviral treatment response.


METHODS
Using univariate and multivariate analysis, we retrospectively evaluated biochemical, metabolic, genetic and viral variables that might affect both RVR and SVR to Peg-IFN plus ribavirin, in 315 consecutive outpatients affected by HCV-related chronic hepatitis.


RESULTS
At univariate analysis, staging, body mass index, RVR, genotype and viral load were significantly related to SVR (P < 0.001). At multivariate analysis, RVR and genotype remained significant (P < 0.00001). The RVR had a predictive value of 83%. At univariate and multivariate analyses, diabetes (P = 0.003), genotype 2 (P = 0.000) and HCV-RNA values (P = 0.016) were independent predictors of RVR, even though at multivariate analyses, only genotype 2 was significantly related to RVR. When we stratified patients, according to genotype, no laboratory or clinical factors were predictive of RVR in genotype 1 patients at either univariate or multivariate analysis. In genotype 2 patients, staging (P = 0.029) and diabetes (P = 0.001) were the only significant predictors of RVR at univariate analyses, whereas no factor was independently related to RVR, at multivariate analysis.


CONCLUSIONS
The RVR is the strongest factor of SVR and infection with HCV genotype 2 is significantly associated with RVR. Neither biochemical and/or metabolic factors seem to exert influence on RVR.
Department of Clinical and Experimental Medicine, Division of Hepatogastroenterology, Second University of Naples, Naples, Italy.
Alessandro
A
Federico
Department of Internal Medicine and Hepatology, Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy.
Mario
M
Masarone
Department of Clinical and Experimental Medicine, Division of Hepatogastroenterology, Second University of Naples, Naples, Italy.
Marco
M
Romano
Department of Clinical and Experimental Medicine, Division of Hepatogastroenterology, Second University of Naples, Naples, Italy.
Marcello
M
Dallio
IV Division of Internal Medicine and Hepatology, Second University of Naples, Naples, Italy.
Valerio
V
Rosato
Department of Internal Medicine and Hepatology, Internal Medicine and Hepatology Unit, University of Salerno, Salerno, Italy.
Marcello
M
Persico
Antiviral Agents; Hepatitis C; Pegylated Interferon SA; Retrospective Studies; Ribavirin