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Ultra-rapid virological response, young age, low ?-GT/ALT-ratio, and absence of steatosis identify a subgroup of HCV Genotype 3 patients who achieve SVR with IFN-?(2a) monotherapy.


ABSTRACT:

Background and aims

The standard treatment regimen for chronic HCV genotype 3 (HCV-G3) hepatitis consists of PEGylated interferon-? (IFN-?) and ribavirin at varying doses ranging from 400 to 1,200 mg and results in response rates of 80%. However, this therapy has substantial side-effects including anemia, is teratogenic, and costly. To reduce the side-effects of therapy, the role of monotherapy consisting of only IFN-? was investigated.

Methods

A retrospective analysis of individual therapy courses of HCV-G3-infected patients who were treated with IFN-?(2a) monotherapy or a combination therapy with attention to the treatment outcome and the presence of IL28B rs12979860 and IL28B rs8099917 single-nucleotide polymorphism genotypes was performed. Conventional prognostic features in each case were assessed as well.

Results

In the study, 15/30 (50%) of patients treated with IFN-?(2a) monotherapy and 32/36 (89%) treated with combination therapy achieved a sustained virological response (SVR). In addition, 7/11 (64%) of those treated initially with monotherapy and subsequently with combination therapy achieved an SVR. An "ultra-rapid" virological response occurring within 2 weeks of initiation of therapy (p = 0.005), young age (<40; p < 0.001) and low initial ?-GT/ALT-ratio (p = 0.03) were associated with a SVR to IFN-?(2a) monotherapy. An SVR in those treated with combination therapy was found to be associated with a rapid virological response (RVR) (p = 0.03). The absence of histologic steatosis was associated with SVR in all patient groups (p = 0.01). Therapy duration (24 vs. 48 weeks) did not affect the SVR in either group. As expected, combination therapy resulted in more hematological side-effects than did monotherapy.

Conclusions

An "ultra-rapid" virological response, young age, low initial ?-GT/ALT-ratio and absence of steatosis were each associated with an SVR in those receiving IFN-?(2a) monotherapy. Therefore, monotherapy in these patients should still be discussed independently of the existence of the IL28B polymorphisms.

SUBMITTER: Amanzada A 

PROVIDER: S-EPMC3208815 | biostudies-literature | 2011 Nov

REPOSITORIES: biostudies-literature

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Ultra-rapid virological response, young age, low γ-GT/ALT-ratio, and absence of steatosis identify a subgroup of HCV Genotype 3 patients who achieve SVR with IFN-α(2a) monotherapy.

Amanzada Ahmad A   Goralczyk Armin A   Moriconi Federico F   Blaschke Martina M   Schaefer Inga-Marie IM   van Thiel David D   Mihm Sabine S   Ramadori Giuliano G  

Digestive diseases and sciences 20111013 11


<h4>Background and aims</h4>The standard treatment regimen for chronic HCV genotype 3 (HCV-G3) hepatitis consists of PEGylated interferon-α (IFN-α) and ribavirin at varying doses ranging from 400 to 1,200 mg and results in response rates of 80%. However, this therapy has substantial side-effects including anemia, is teratogenic, and costly. To reduce the side-effects of therapy, the role of monotherapy consisting of only IFN-α was investigated.<h4>Methods</h4>A retrospective analysis of individu  ...[more]

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