Treatment and retreatment in patients with chronic hepatitis C: 10 years clinical practice in a single centre

Authors

  • Michael S. Economou,

    1. 1st Department of Internal Medicine and Hepato-Gastroenterology Unit, School of Medicine, University of Ioannina, Ioannina, Greece
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  • Spyridon Filis,

    1. 1st Department of Internal Medicine and Hepato-Gastroenterology Unit, School of Medicine, University of Ioannina, Ioannina, Greece
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  • Helen Vienna,

    1. 1st Department of Internal Medicine and Hepato-Gastroenterology Unit, School of Medicine, University of Ioannina, Ioannina, Greece
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  • Dimitrios Christodoulou,

    1. 1st Department of Internal Medicine and Hepato-Gastroenterology Unit, School of Medicine, University of Ioannina, Ioannina, Greece
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  • Leonidas Christou,

    1. 1st Department of Internal Medicine and Hepato-Gastroenterology Unit, School of Medicine, University of Ioannina, Ioannina, Greece
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  • Epameinondas V. Tsianos

    1. 1st Department of Internal Medicine and Hepato-Gastroenterology Unit, School of Medicine, University of Ioannina, Ioannina, Greece
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Correspondence
Michael Economou, 1st Department of Internal Medicine and Hepato-Gastroenterology Unit, School of Medicine, University of Ioannina, Ioannina 45110, Greece.
Tel: +30 2651 97501
Fax: +30 26510 97016
e-mail: meconom@cc.uoi.gr

Abstract

Aim: Therapy for chronic hepatitis C (HCV) has mainly been evaluated in large clinical, select population, trials. We sought to evaluate whether prognostic factors of therapeutic response are similar in clinical practice, where treated population is more diverse.

Methods: Retrospective study of HCV-infected patients who completed >6 months of treatment/retreatment with various therapeutic regimens, in a single reference centre over a 10-year period. Adjuvant treatment with hemopoetic growth factors was used when warranted by treatment side effects.

Results: Overall, 77/125 patients (61.6%) achieved sustained virological response (SVR). Fifty-four naïve patients (43.2%) achieved SVR; 19 (26%) with interferon-α (IFN-α), 13 (59.1%) with IFN-α and ribavirin, and 22 (73.3%) with pegylated IFN-α and ribavirin. Seventeen patients responded after two courses of therapy and six after more than three courses, achieving a total SVR of 32%. Patients with genotype-1 were less probable to achieve SVR [odds ratio (OR)=6.23], while younger patients were more possible to achieve SVR, OR=0.97. Most non-responders after >2 regimens were genotype-1 patients (90%).

Conclusions: In clinical practice, where strict selection criteria cannot be applied, genotype-1 remains the most significant prognostic factor of response failure. Addition of adjuvant hemopoetic growth factors, when warranted, may increase compliance and thus overall SVR.

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