The follow-up results with sustained virologic response in chronic hepatitisC patients in Sanliurfa/Turkey

Abstract

Objectives: The aim of the study was to evaluate sustained virological response (SVR) after treatment and factors that influence SVR among patients treated for chronic hepatitis C (CHC). Materials and methods: The study was conducted in patients with CHC between April 2007 and March 2011, who had achieved SVR following treatment. They were treated with PEG IFN-&alpha; and ribavirin. Patients, whose end of treatment responses were obtained without a SVR, received a second course of treatment. Results: A total of 124 patients, 61 female (49.2%) were enrolled in the study. The distribution of genotypes was: 102 patients with genotype 1 (82.3%) and 22 with genotype 2 (17.7%). SVR was achieved in 78 patients (62.9%) (67 during the first course and 11 in the second) were followed up for a mean duration of 18.4&plusmn;8.5 months. Positive predictive factors on SVR were female gender (P=0.01), low initial viral load (P=0.01), early virological response (EVR) development (P<0.001) and infection with genotype 2 (P<0.001). Conclusions: In conclusion, there was no recurrence of HCV infection beyond follow-up of 24 months in any of the patients who obtained SVR. Female gender, low initial viral load, development of EVR and infection with genotype 2 was determined to have a positive impact on SVR.

Keywords

• Chronic hepatitis C, genotype, sustained virological response, therapy.

The follow-up results with sustained virologic response in chronic hepatitisC patients in Sanliurfa/Turkey

Abstract

Keywords

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References

1. Lavanchy D. The global burden of hepatitis C. Liver Int 2009; 29: 74-81.
2. Shepard CW, Finelli L, Alter MJ. Global epidemiology of hepa- titis C virus infection. Lancet Infect Dis 2005; 5: 558–567.
3. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of hepatitis C virus infec- tion. J Hepatology 2011; 55:245-264.
4. Thompson CJ, Rogers G, Hewson P, et al. Surveillance of cir- rhosis for hepatocellular carcinoma: systematic review and economic analysis. Health Technol Asess 2007; 11:1-206.
5. Simmonds P, Bukh J, Combet C, et al. Consensus propos- als for a unified system of nomenclature of hepatitis C virus genotypes. Hepatology 2005; 42: 962-973.
6. Esteban JI, Sauleda S, Quer J. The changing epidemiology of hepatitis C virus infection in Europe. J Hepatol 2008; 48:148- 162.
7. Fried MW, Shiffman ML, Reddy KR, et al. Peginterferon alfa- 2a plus ribavirin for chronic 6 hepatitis C virus infection. N Eng J Med 2002; 347:975-982.
8. Hadziyannis SJ, Sette H, Morgan T, et al. Peginterferon al- fa-2a (40 kilodaltons) andribavirin combination therapy in chronic hepatitis C: randomized study of treatment duration and ribavirin dose. Ann Intern Med 2004; 140:346-357.

9. Manns MP, Wedemeyer H, Cornberg M. Treating viral hepatitis C: efficacy, side effects, and complications. Gut 2006; 55: 1350–1359.
10. Strader DB, Wright T, Thomas DL, Seelf LB, Diagnosis, management and treatment of hepatitis C. AASLD Practice Guidelines. Hepatology 2004; 1147-1158.
11. Michelin BD, Muller Z, Stelzl E, Marth E, Kessler HH. Evalu- ation of the Abbott Real Time HCV assay for quantitative de- tection of hepatitis C virus RNA. J Clin Virol 2007; 38:96-100.
12. Stuyver L, Wyseur A, van Arnhem W, Hernandez F, Maertens G. Second generation line probe assay for hepatitis C virus genotyping. J Clin Microbiol 1996; 34:2259-2266.
13. Yun Z, Lara C, Johansson B, Lorenzana de Rivera I, Son- nerborg A. Discrepancy of hepatitis C virus genotypes as determined by phylogenetic analysis of partial NS5 and core sequences. J Med Virol 1996; 49:155-160.
14. Ishak K, Baptista A, Bianchi L, et al. Histological grading and staging of chronic hepatitis. J Hepatol 1995: 22:696-699.
15. The Global Burden of Hepatitis C Working Group. Global burden of disease (GBD) for hepatitis C. J Clin Pharmacol 2004; 44: 20-29.
16. Brok J, Gluud LL, Gluud C. Meta-analysis: Ribavirin plus in- terferon vs. interferon monotherapy for chronic hepatitis C– an updated Cochrane review. Aliment Pharmacol Ther 2010; 32:840-850.
17. Ghany MG, Strader DB, Thomas DL, Seeff LB. American As- sociation for the Study of Liver Diseases. Diagnosis, man- agement, and treatment of hepatitis C: an update. Hepatol- ogy 2009; 49:1335–1374.
18. Scott JD, Gretch DR. Molecular diagnostics of hepatitis C vi- rus infection. A systematic review. JAMA 2007; 297:724-732.
19. Gokahmetoglu S, Bozdayı M, Ozbakır O, et al. Hepatitis C virus genotypes detected in Erciyes University. J Turk Mikro- biol Society 2007; 37:35-38 (In Turkish).
20. Altuglu I, Soyler I, Ozacar T, Erensoy S. Distribution of hepa- titis C virus genotypes in patients with chronic hepatitis C in- fection in Western Turkey. Int J Infect Dis 2008; 12:239-244.
21. Kuçukoztas MF, Ozgunes N, Yazıcı S. Investigation of the relationship between Hepatitis C virus (HCV) genotypes with HCV-RNA and alanine aminotransferase levels in chronic hepatitis C patients. Mikrobiyol Bul 2010; 44:111-5.
22. Cil T, Ozekinci T, Goral V, Altıntas A. Hepatitis C virus geno- types in the southeast region of Turkey. Turkiye Klinikleri J Med Sci 2007; 27:496-500.
23. Cernescu C, Ruta S, Gheorghe L, Iacob S, Popescu I, Wan- less RS. The Flying Publisher Guide to Hepatitis C Treat- ment. Flying Publisher 2011. edn. www.ingpublisher.com.
24. Alter MJ. Epidemiology of hepatitis C virus infection. World J Gastroenterol 2007; 13:2436-41.
25. Akhan S, Aynıoglu A, Sargın E, Sayan M. Evaluation of Treat- ment Results of Patients with Chronic Hepatitis C Followed for Five Years. Klimik J 2010; 23(2): 39-43 (In Turkish).
26. Mathew A, Peiffer LP, Rhoades K, McGarrity T. Sustained viral response to pegylated interferon alpha-2b and ribavirin in chronic hepatitis C refractory to prior treatment. Dig Dis Sci 2006; 51(11): 1956-61.
27. Zeuzem S. Heterogeneous virologic response rates to in- terferon-based therapy in paytients with chronic hepatitis C: who respond less well? Ann Intern Med 2004; 40: 993-999.
28. Petta S, Craxı` A. Optimal therapy in hepatitis C virus geno- types 2 and 3 patients. Liver7 Intern 2011; 36-44.
29. McHutchison J, Sulkowski M. Scientific rationale and study design of the individualized dosing efficacy vs. flat dosing to assess optimal pegylated interferon therapy (IDEAL) tri- al: determining optimal dosing in patients with genotype 1 chronic hepatitis C. J Viral Hepat 2008; 15: 475-481.
30. Awad T, Thorlund K, Hauser G, Stimac D, Mabrouk M, Gluud C. Peginterferon alpha-2a is associated with higher sustained virological response than peginterferon alfa-2b in chronic hepatitis C: systematic review of randomized trials. Hepatology 2010; 51: 1176-1184.
31. Desmond CP, Roberts SK, Dudley F, et al. Sustained viro- logical response rates and durability of the response to in- terferon based therapies in hepatitis C patients treated in the clinical setting. J Viral Hepat 2006; 13: 311-315.
32. Ferreira SC, MV Carneiro, Souza FF, et al. Long-term follow- up of patients with chronic hepatitis C with sustained virologic response to interferon. Braz J Infect Dis 2010; 14: 330-334.