title: Short interferon and ribavirin treatment for HCV genotype 2 or 3 infection: NORDynamIC trial and real-life experience.
abstract: OBJECTIVE
  Interferon-free therapy for hepatitis C virus (HCV) infection is costly, and therefore patients with advanced fibrosis are prioritized. Although coupled with considerable side effects, a large proportion of genotype 2/3 infected patients achieve a sustained virological response (SVR) following interferon-based therapy. The present study evaluates experimental clinical trial and verifying real-life data with the aim of identifying patients with a high likelihood of favorable outcome following short interferon-based treatment.
  
  
  METHODS
  The impact of established response predictors, e.g. age, ITPA and IL28B genetic variants, IP-10, liver histopathology and early viral kinetics on outcome was evaluated among HCV genotype 2/3 infected patients enrolled in the NORDynamIC trial. Similarly outcome was evaluated among Finnish and Swedish real-life genotype 2/3 infected patients treated for 12-16 weeks in accordance with national guidelines.
  
  
  RESULTS
  In the NORDynamIC trial, age < 40 years or achieving HCV RNA < 1000 IU/mL day 7 were highly predictive of favorable outcome following 12 weeks therapy. Among 255 Finnish real-life patients below the age of 40 years treated for 12 weeks with interferon and ribavirin, 87% of HCV genotype 2 and 79% of genotype 3 infected patients achieved SVR, and among 117 Swedish real-life patients treated for 12-16 weeks, 97% of HCV genotype 2 and 94% of genotype 3 infected achieved SVR.
  
  
  CONCLUSIONS
  Short interferon-based therapy offers a high likelihood of achieving SVR for selected HCV genotype 2/3 infected patients, and is an acceptable option given that a thorough discussion of the side effects is provided prior to initiation.
authors.affiliation: a Department of Infectious Medicine/Virology , Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg , Sweden ;
authors.forename: Jesper
authors.initials: J
authors.lastname: Waldenström
authors.affiliation: b Clinic of Gastroenterology, Helsinki University Hospital, University of Helsinki , Helsinki , Finland ;
authors.forename: Martti
authors.initials: M
authors.lastname: Färkkilä
authors.affiliation: a Department of Infectious Medicine/Virology , Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg , Sweden ;
authors.forename: Karolina
authors.initials: K
authors.lastname: Rembeck
authors.affiliation: a Department of Infectious Medicine/Virology , Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg , Sweden ;
authors.forename: Gunnar
authors.initials: G
authors.lastname: Norkrans
authors.affiliation: c Department of Clinical Science , University of Bergen , Bergen , Norway ;|d Department of Medicine , Haukeland University Hospital , Bergen , Norway ;
authors.forename: Nina
authors.initials: N
authors.lastname: Langeland
authors.affiliation: d Department of Medicine , Haukeland University Hospital , Bergen , Norway ;
authors.forename: Kristine
authors.initials: K
authors.lastname: Mørch
authors.affiliation: e Department of Infectious Diseases , University of Southern Denmark , Odense , Denmark ;
authors.forename: Court
authors.initials: C
authors.lastname: Pedersen
authors.affiliation: f Department of Infectious Diseases , Aarhus University , Aarhus , Denmark ;
authors.forename: Mads
authors.initials: M
authors.lastname: Rauning Buhl
authors.affiliation: b Clinic of Gastroenterology, Helsinki University Hospital, University of Helsinki , Helsinki , Finland ;
authors.forename: Urpo
authors.initials: U
authors.lastname: Nieminen
authors.affiliation: b Clinic of Gastroenterology, Helsinki University Hospital, University of Helsinki , Helsinki , Finland ;
authors.forename: Hannu
authors.initials: H
authors.lastname: Nuutinen
authors.affiliation: g Infektion, Skaraborgs Sjukhus Skövde , Skövde , Sweden ;
authors.forename: Åsa
authors.initials: Å
authors.lastname: Alsiö
authors.affiliation: h Infektionskliniken, Hallands sjukhus , Halmstad , Sweden ;
authors.forename: Lars
authors.initials: L
authors.lastname: Holmström
authors.affiliation: i Infektionskliniken, Södra Älvsborgs Sjukhus , Borås , Sweden ;
authors.forename: Rolf
authors.initials: R
authors.lastname: Jungnelius
authors.affiliation: j Infektionskliniken, NÄL , Trollhättan , Sweden ;
authors.forename: Katarina
authors.initials: K
authors.lastname: Lund
authors.affiliation: k Infektionskliniken, Centralsjukhuset , Karlstad , Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Rubensson
authors.affiliation: l Infektionskliniken, Gävle Sjukhus , Gävle , Sweden.
authors.forename: Erik
authors.initials: E
authors.lastname: Torell
authors.affiliation: a Department of Infectious Medicine/Virology , Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg , Sweden ;
authors.forename: Johan
authors.initials: J
authors.lastname: Westin
authors.affiliation: a Department of Infectious Medicine/Virology , Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg , Sweden ;
authors.forename: Martin
authors.initials: M
authors.lastname: Lagging
mesh_terms: D000328:Adult; D000367:Age Factors; D000998:Antiviral Agents / Q000008:administration & dosage*; D054357:Chemokine CXCL10 / Q000097:blood; D004359:Drug Therapy, Combination; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000235:genetics* / Q000821:virology; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage*; D007372:Interferons; D007378:Interleukins / Q000235:genetics; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011755:Pyrophosphatases / Q000235:genetics / Q000378:metabolism; D012367:RNA, Viral / Q000097:blood*; D011994:Recombinant Proteins / Q000008:administration & dosage; D012254:Ribavirin / Q000008:administration & dosage*; D012537:Scandinavian and Nordic Countries; D016896:Treatment Outcome; D000095022:Interferon Lambda; D000097630:Inosine Triphosphatase
chemical_list: D000998:Antiviral Agents; D054357:Chemokine CXCL10; D016898:Interferon-alpha; D007372:Interferons; D007378:Interleukins; D011092:Polyethylene Glycols; D011755:Pyrophosphatases; D012367:RNA, Viral; D011994:Recombinant Proteins; D012254:Ribavirin; C114753:CXCL10 protein, human; C000624353:interferon-lambda, human; D000095022:Interferon Lambda; C511829:ITPA protein, human; D000097630:Inosine Triphosphatase; C100416:peginterferon alfa-2a
keywords: ITPA; genotype 2; genotype 3; hepatitis C virus; inosine triphosphate pyrophosphatase; interferon; ribavirin