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Variables may predict HCV patients likely to respond to peginterferon/ribavirin

Using baseline data in combination with rapid virologic response status, researchers reported they may be able to predict which hepatitis C genotype 1 treatment-naive patients will benefit most from conventional dual therapy with pegylated interferon and ribavirin, according to study data.

“The growing enthusiasm about embracing new therapies should not obscure the notion that an appreciable number of HCV-1 infected patients are able to eliminate the virus with conventional dual therapies,” the researchers wrote. “We estimated the magnitude of these patients to amount to 20%, a figure which is constituted by the great majority of patients experiencing RVR [rapid virologic response].”

Angelo Andriulli

The retrospective analysis examined records of 1,045 patients who received peginterferon alfa-2b or alfa-2a plus ribavirin for HCV genotype 1 at 15 centers in Italy between 2005 and 2010. Among all patients, 39.6% achieved sustained virologic response (SVR). Of the 24.4% of patients who demonstrated rapid virologic response, however, 80% also achieved SVR.

The researchers then determined which baseline characteristics, along with RVR, identified this subset of patients likely to achieve SVR from traditional therapy. RVR was demonstrated in 186 patients who displayed absent to moderate levels of fibrosis (F0-F2). Of these, 42 also had interleukin 28B CC genotype and low viremia (<400,000 IU), and all achieved SVR.

Of the same 186, 55 patients had IL28B CC and high viremia, and 47 (85.5%) achieved SVR. Among the 53 without IL28B CC and with low viremia, 42 (79.2%) achieved SVR. Of the remaining 36 without IL28B CC and with high viremia, only 20 (55.6%) achieved SVR.

Among the RVR patients, 69 had high fibrosis (F3 and F4). Eleven of the high fibrosis patients had IL28B CC and low viremia, and all reached SVR. None of the remaining subgroups reached an 80% cure rate, with the low viremia patients without IL28B CC peaking at 76.5%.

“A consistent subset of naive HCV-1 patients, identified by some baseline characteristics and RVR, may benefit from dual treatment with peginterferon and ribavirin,” the researchers concluded.

Disclosure: The researchers report no relevant financial disclosures.