viral kinetics during the first month of treatment in patients with genotype 1 chronic hepatitis c cinética viral durante el primer mes de tratamiento en pacientes con hepatitis crónica c genotipo 1

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ID: 141199
2009
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Abstract
Objective: to identify predictive factors of response to pegylated interferon alpha-2b and ribavirin in patients with genotype 1 chronic hepatitis C. Viral kinetics were studied in weeks 2 and 4. Methods: a prospective and consecutive study of patients with genotype 1 chronic hepatitis C referred to our Hepatology Clinic between January 2004 and October 2006 for antiviral treatment. Baseline data were recorded and viremia levels were determined hours before the weekly dose of pegylated interferon by qualitative and quantitative PCR. Results: 57 patients were included in the study, although 3 of these were excluded during follow up; 65% were male (n = 35), with a mean age of 42 (26-65) years. Baseline viremia levels were > 800,000 IU/mL in 67% (n = 36). Liver biopsy was performed in 86% (n = 46), 22% (n = 12) had advanced fibrosis. Forty were naïve, 4 relapsing and 10 non-responders. Ribavirin dose was modified in one patient alone due to adverse effects. End treatment response and sustained virological response (SVR) were 59 and 41%, respectively. A univariate analysis revealed a statistically significant association of SVR with baseline viremia (p = 0.006), baseline GGT (p = 0.025), and a reduction in viremia ≥ 2 logs at 2, 4 and 12 weeks (p = 0.001). The extent of viremia reduction at week 2 was associated with 100% SVR, and at 4 weeks the positive predictive values was 84% and the negative predictive values was 96.5%. A subanalysis of the naïve group yielded analogous results. Conclusions: in our study, a reduction in viremia ≥ 2 logs 2 weeks after treatment could ensure SVR. At 4 weeks, most non-responders could be identified.
Objetivo: identificar qué factores predicen la respuesta al interferón pegilado alfa-2b y ribavirina en pacientes con hepatitis crónica C genotipo 1. Se estudió la cinética viral en la semana 2 y 4. Métodos: se evaluaron de forma prospectiva y consecutiva a los pacientes con hepatitis crónica C genotipo 1 remitidos a nuestra consulta de hepatología entre enero de 2004 y octubre de 2006, para tratamiento antiviral. Se recogieron datos basales y la viremia se determinó horas antes de la dosis semanal de interferón pegilado por PCR cualitativa y cuantitativa. Resultados: cincuenta y siete pacientes fueron incluidos aunque 3 fueron excluidos durante el seguimiento. Un 65% fueron varones (n = 35) con edad media de 42 (26-65) años. La viremia basal fue > 800.000 UI/ml en 67% (n = 36). Se realizó biopsia hepática en 86% (n = 46), 22% (n = 12) tenían fibrosis avanzada. 40 fueron naïves, 4 recidivantes y 10 no respondedores. La dosis de ribavirina se modificó por efecto secundario sólo en un paciente. La RFT y la RVS fueron de 59 y 41%, respectivamente. El análisis univariante mostró asociación estadísticamente significativa con RVS de la viremia basal (p = 0,006), GGT basal (p = 0,025) y el descenso en la viremia ≥ 2 logaritmos a las 2, 4 y 12 semanas (p = 0,001). El descenso de la viremia en la semana 2 se asoció con 100% de RVS y a las 4 semanas el VPP fue 84% y el VPN 96,5%. Se realizó un subanálisis en el grupo de pacientes naïves con resultados superponibles. Conclusiones: en nuestro estudio el descenso de la viremia ≥ 2 logaritmos a las 2 semanas de tratamiento aseguró la RVS. A las 4 semanas, identificamos a la gran mayoría de los pacientes no respondedores.
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hernndez2009revistaviral Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors ;A. Hernández;F. Domper;A. León;R. Lorente;B. López;E. de la Santa;M. Cabanillas;R. Patón;J. Olmedo;M. D. Galván;E. Rodríguez
Journal chemistry of heterocyclic compounds
Year 2009
DOI
DOI not found
URL
http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1130-01082009001000002
Keywords
treatment hepatitis c viremia Gastroenterology

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