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ABSTRACT: Background
Previous trials have often defined genotype 2 and 3 patients as an "easy to treat" group and guidelines recommend similar management.Aims
The present study looks for differences between the two genotypes and analyzes predictive factors for SVR.Methods
Prospective, community-based cohort study involving 421 physicians throughout Germany. The analysis includes 2,347 patients with untreated chronic HCV genotype 2 (n?=?391) and 3 (n?=?1,956) infection treated with PEG-IFN ?-2a plus ribavirin between August 2007 and July 2012.Results
When compared with genotype 2 patients, those with genotype 3 were younger, had a shorter duration of infection, lower values of total cholesterol, LDL cholesterol and BMI, a higher frequency of drug use as infection mode and male gender (p<0.0001, respectively), and a higher APRI score (p<0.005). SVR was higher in genotype 2 when compared with genotype 3 (64.7% vs. 56.9%, p?=?0.004). By multivariate analysis of genotype 2 patients, low baseline ? -GT and RVR predicted SVR. In genotype 3 age ?45 years, cholesterol>130 mg/dl, a low APRI score, and a ?-GT ?3-times ULN, RVR, and RBV starting dose were associated with SVR by multivariate analysis.Conclusions
The present study corroborates that liver fibrosis is more pronounced in genotype 3 vs. 2. SVR is higher in genotype 2 versus genotype 3 partly because of follow-up problems in genotype 3 patients, in particular in those infected by drug use. Thus, subgroups of genotype 3 patients have adherence problems and need special attention also because they often have significant liver fibrosis.Trial registration
Verband Forschender Arzneimittelhersteller e.V., Berlin, Germany ML21645 ClinicalTrials.gov NCT02106156.
SUBMITTER: Niederau C
PROVIDER: S-EPMC4169557 | biostudies-literature | 2014
REPOSITORIES: biostudies-literature
Niederau Claus C Mauss Stefan S Schober Andreas A Stoehr Albrecht A Zimmermann Tim T Waizmann Michael M Moog Gero G Pape Stefan S Weber Bernd B Isernhagen Konrad K Sandow Petra P Bokemeyer Bernd B Alshuth Ulrich U Steffens Hermann H Hüppe Dietrich D
PloS one 20140919 9
<h4>Background</h4>Previous trials have often defined genotype 2 and 3 patients as an "easy to treat" group and guidelines recommend similar management.<h4>Aims</h4>The present study looks for differences between the two genotypes and analyzes predictive factors for SVR.<h4>Methods</h4>Prospective, community-based cohort study involving 421 physicians throughout Germany. The analysis includes 2,347 patients with untreated chronic HCV genotype 2 (n = 391) and 3 (n = 1,956) infection treated with ...[more]