title: Changes in the response to treatment against chronic hepatitis C between 1999 and 2015: data from a prospective cohort.
abstract: BACKGROUND
  The drug options and strategies for treatment against hepatitis C virus (HCV) infection have changed considerably in the last few years. The aim of this study was to compare the changes in the proportion of nonresponders and patients who achieved a sustained virologic response (SVR) from 1999 to 2015 in one single cohort.
  
  
  METHODS
  A total of 522 patients treated against chronic hepatitis C were included prospectively. The time periods were 1999-2002 [interferon (IFN)/ribavirin (RBV)], 2002-2009 (pegylated-IFN/RBV), 2010-2011 (use of IL28B genotype), 2012-2014 (pegylated-IFN/RBV/direct-acting antivirals) and 2015 (IFN-free direct-acting antiviral-based therapy).
  
  
  RESULTS
  The numbers of nonresponders in the study periods in chronological order were as follows: 14 (40%), 76 (21.3%), 7 (8%), 10 (13%), and 0; P=1.1×10 and r=0.837. The corresponding numbers of patients who achieved SVR were 9 (25.7%), 14 (40.9%), 44 (50.6%), 51 (66.2%), and 64 (90.1%), P=3.3×10 and r=0.997. Characteristics that may impair SVR, such as advanced fibrosis, genotype 1 infection, HIV coinfection, or treatment experience, did not decrease in the last time periods.
  
  
  CONCLUSIONS
  The proportion of nonresponders was significantly reduced using the IL28B genotype as a predictive tool and direct-acting antivirals further improved treatment outcome. Concomitantly, the rates of SVR showed a linear increase.
authors.affiliation: aUnit of Infectious Diseases and Microbiology bInternal Medicine Department, Hospital Universitario de Valme cBiomedical Institute of Seville (IBIS), Seville, Spain.
authors.forename: María
authors.initials: M
authors.lastname: Mancebo
authors.forename: Luis M
authors.initials: LM
authors.lastname: Real
authors.forename: José A
authors.initials: JA
authors.lastname: Mira
authors.forename: Eva
authors.initials: E
authors.lastname: Recio
authors.forename: Elisabet
authors.initials: E
authors.lastname: Pérez
authors.forename: Patricia
authors.initials: P
authors.lastname: Monje-Agudo
authors.forename: Nicolás
authors.initials: N
authors.lastname: Merchante
authors.forename: Juan
authors.initials: J
authors.lastname: Macías
authors.forename: Karin
authors.initials: K
authors.lastname: Neukam
authors.forename: Juan A
authors.initials: JA
authors.lastname: Pineda
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000150:complications; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D007372:Interferons; D007378:Interleukins / Q000235:genetics; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D000072230:Sustained Virologic Response; D017211:Treatment Failure; D000095022:Interferon Lambda
chemical_list: D000998:Antiviral Agents; D007372:Interferons; D007378:Interleukins; D012367:RNA, Viral; C000624353:interferon-lambda, human; D000095022:Interferon Lambda