A Predictive Model for Selecting Patients with HCV Genotype 3 Chronic Infection with a High Probability of Sustained Virological Response to Peginterferon Alfa-2a/Ribavirin
Background Access to direct-acting antiviral agents (DAAs) is restricted in some settings; thus, the Euro pean Association for the Study of the Liver recommends dual peginterferon/ribavirin (PegIFN/RBV) therapy wherever DAAs are unavailable. HCV genotype (GT) 3 infection is now the most difficult ge...
| Autores: | , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2016 |
| País: | España |
| Institución: | Universidad de Sevilla (US) |
| Repositorio: | idUS. Depósito de Investigación de la Universidad de Sevilla |
| OAI Identifier: | oai:idus.us.es:11441/108574 |
| Acceso en línea: | https://hdl.handle.net/11441/108574 https://doi.org/10.1371/journal.pone.0150569 |
| Access Level: | acceso abierto |
| Palabra clave: | HCV Genotype 3 Peginterferon Alfa-2a/Ribavirin |
| Sumario: | Background Access to direct-acting antiviral agents (DAAs) is restricted in some settings; thus, the Euro pean Association for the Study of the Liver recommends dual peginterferon/ribavirin (PegIFN/RBV) therapy wherever DAAs are unavailable. HCV genotype (GT) 3 infection is now the most difficult genotype to eradicate and PegIFN/RBV remains an effective option. The goal of this study was to devise a simple predictive score to identify GT3 patients with a high probability of achieving a sustained virologic response (SVR) with PegIFN alfa-2a/RBV therapy. Methods Relationships between baseline characteristics and SVR were explored by multiple logistic regression models and used to develop a simple scoring system to predict SVR using data from 1239 treatment-naive GT3 patients who received PegIFN alfa-2a/RBV for 24 weeks in two large observational cohort studies. Results The score was validated using a database of 473 patients. Scores were assigned for six fac tors as follows: age (years) ( 40: 2 points; >40 but 55: 1); bodyweight (kg) (<70: 2; 70 but <90: 1); no cirrhosis/transition to cirrhosis (2); ALT 2.5 x ULN (1); platelets (109 /L) (>200: 2; 100 but <200: 1); HCV RNA (<400,000 IU/mL: 1). The points are summed to arrive at a score ranging from 0-10 where higher scores indicate higher chances of SVR; 141, 123, 203, 249, 232, and 218 patients had total scores of 0-4, 5, 6, 7, 8, and 9–10, respectively, among whom SVR rates were 45%, 62%, 72%, 76%, 84%, and 89%. Among 622 patients who had scores of 6-10 and HCV RNA <50 IU/mL by treatment week 4 the SVR rate was 86% (532/622). |
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