Predictors of a sustained virological response in patients with genotype 4 chronic hepatitis C
Article first published online: 7 APR 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Munksgaard
Volume 28, Issue 8, pages 1112–1119, September 2008
How to Cite
Gad, R. R., Males, S., El Makhzangy, H., Shouman, S., Hasan, A., Attala, M., El Hoseiny, M., Zalata, K., Abdel-Hamid, M., Fontanet, A., Mohamed, M. K. and Esmat, G. (2008), Predictors of a sustained virological response in patients with genotype 4 chronic hepatitis C. Liver International, 28: 1112–1119. doi: 10.1111/j.1478-3231.2008.01750.x
- Issue published online: 6 AUG 2008
- Article first published online: 7 APR 2008
- Received 30 November 2007Accepted 28 February 2008
- adherence to treatment;
- chronic hepatitis C;
- pegylated interferon;
- sustained virological response;
- treatment response predictors
Objectives: To determine the clinical, biological, virological and histological predictive factors associated with a sustained virological response (SVR) to combined interferon therapy among Egyptian patients infected by genotype 4 hepatitis C virus (HCV).
Patients and Methods: Individual data from 250 patients with genotype 4 chronic hepatitis C, treated with different regimens of combined interferon, were analysed. The primary end point was SVR defined as undetectable HCV RNA by polymerase chain reaction (PCR) 24 weeks after the end of treatment. Multivariate logistic regression analysis was performed to select the independent prognostic parameters associated with SVR.
Results: A sustained virological response was achieved among 137/250 (54.8%) patients. Baseline factors independently and negatively associated with SVR were serum α-fetoprotein (AFP) level (above 0.3 upper limit of normal) [odds ratio (OR)=0.5, 95% confidence interval (CI): 0.2–0.8], severe fibrosis (Metavir score >F2) (OR=0.4, 95% CI: 0.2–0.8), presence of steatosis (OR=0.5, 95% CI: 0.3–0.97) and standard interferon treatment (OR=0.4, 95% CI: 0.2–0.8).
Conclusions: Among genotype 4 chronic hepatitis C patients, severe fibrosis, severe steatosis, treatment with standard interferon and a high serum AFP level were all negatively associated with SVR. Pretreatment serum AFP level should be considered in the routine assessment of factors predictive of a treatment response.