Sustained Virological Response Rates to Antiviral Therapy in Genotype 1 and 3 Chronic Hepatitis C Patients: A Study from North India
Sustained Virological Response Rates to Antiviral Therapy in Genotype 1 and 3 Chronic Hepatitis C Patients: A Study from North India
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DOI：
10.1016/j.jceh.2014.08.004
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发表时间：
2014-12-01
影响因子：
3
通讯作者：
Arora, Anil
中科院分区：
文献类型：
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作者：
Gupta, Varun;Kumar, Ashish;Arora, Anil
背景：在印度，基因型3和1是慢性丙型肝炎（CHC）患者的主要基因型。然而，有很少的数据持续的病毒反应（SVR）率与常规推荐的双重治疗与PEG-IFN和利巴韦林。研究方法：在这项回顾性研究中，纳入了在我院消化内科单个科室接受PEG-IFN和病毒唑治疗的基因型1和3型CHC连续患者。排除合并HIV或HBV感染的患者。结果：共有114例患者纳入研究，中位年龄44（15-72）岁，79%为男性。最常见的表现是慢性肝炎，而10例（9%）患者有代偿性肝硬化。9例（8%）患者有相关糖尿病，16例（14%）患者有严重酗酒史。中位基线HCV RNA水平为3.0 x 10（5）（1.7 x 10（3）-1.8 x 10（7））IU/mL。最常见的基因型是3（75%），其次是基因型1（25%）。70%的患者接受PegIFN-α 2a（中位剂量180 MIU/周），30%的患者接受PegIFN-α 2b（中位剂量80 MIU/周）。利巴韦林的中位剂量为800（范围800-1200）mg。基因型1的SVR为64%（18/28），基因型3的SVR为73%（63/86）。单变量分析中预测SVRon的因素是基线HCVRNA水平较低（低于3.0 × 10（5））、血红蛋白水平较高（> 11.8 g/dl）、达到快速病毒学应答（RVR）、早期病毒学应答（EVR）和治疗结束应答（ETR）。在多变量分析中，发现与SVR独立相关的唯一基线因素是低HCV RNA水平（< 3.0 × 10（5）IU/mL）（P = 0.003）。结论：在印度北部，HCV基因型3的SVR率为73%，与用PEG-IFN和利巴韦林治疗时基因型1的SVR率64%相当。基线HCV RNA水平低于3.0 × 10（5）最好预测SVR，除了实现RVR，EVR或ETR。
Background: In India, both genotype 3 and 1 are predominant genotypes in patients with chronic hepatitis C (CHC). However, there is scanty data on sustained viral response (SVR) rate with conventionally recommended dual therapy with PEG-IFN and ribavirin. Methods: In this retrospective study, consecutive patients of CHC of genotypes 1 and 3, attending the single unit of Gastroenterology of our hospital, who received PEG-IFN and ribavirin therapy, were included. Patients who had co-infection with HIV or HBV were excluded. Results: A total of 114 patients were included in the study median age 44 (15-72) years, 79% males. Most common presentation was with chronic hepatitis, while 10 (9%) patients had compensated cirrhosis. Nine (8%) patients had associated diabetes, 16 (14%) patients gave history of significant alcohol abuse. The median baseline HCV RNA level was 3.0 x10(5) (1.7 x 10(3) -1.8 x 10(7)) IU/mL. The most common genotype was 3 (75%) followed by genotype 1 (25%). 70% patients received PegIFN-alpha 2a (median dose 180 MIU/wk) and 30% patients received PegIFN-alpha 2b (median dose 80MIU/wk). Themedian ribavirin dose was 800 (range 800-1200) mg. SVR in genotype 1 was 64% (18/28) while SVR in genotype 3was 73%(63/86). The factors predicting SVRon univariate analysis were a lower baselineHCVRNAlevel (less than 3.0 x 10(5)), higher hemoglobin level > 11.8 g/dl, and achievement of rapid virological response (RVR), early virological response (EVR) and end of treatment response (ETR). In multivariate analysis the only baseline factor found independently correlating with SVR was low HCV RNA level (< 3.0 x 10(5) IU/mL) (P = 0.003). Conclusion: In north India, HCV genotype 3 has a SVR rate of 73%, which is comparable to genotype 1 with SVR rate of 64% when treated with PEG-IFN and ribavirin therapy. A baseline HCV RNA level lower than 3.0 x 10(5) best predicts SVR in addition to achievement of RVR, EVR or ETR.