de Galocsy C, Kaufman L, Tomasovic S, Delwaide J, Nevens F
Gastroenterology, HIS Bracops Hospital, Brussels, Belgium.
Acta Gastroenterol Belg. 2010 Apr-Jun;73(2):229-34.
Patients with genotype 4 (G4) chronic hepatitis C from the Middle East respond better to treatment than genotype 1 (G1) patients. There are few data on the response rates to treatment of G4 patients living in Western Europe. Many G4 patients in Belgium originate from Central Africa, and their response to treatment seems lower.
We analysed the data from 2 randomized phase III studies conducted in Belgium, BerNar-1 and BerNar-2, comparing the sustained virological response (SVR) to pegylated interferon and ribavirin of 78 G4 patients (34 Caucasians, 44 Blacks) and 477 G1 patients (455 Caucasians, 12 Blacks), and assessing the predictors of SVR.
Baseline characteristics of G4 and G1 patients were similar except mainly for race. Complete early virological response (cEVR) was similar in G4 (73.2%) and G1 (68.1%). cEVR was also similar between Black and Caucasian G4 and between Black and Caucasian G1 patients. Partial early virological response was similar for G4 and G1. SVR was similar for G4 (51.3%) and G1 (51.8%). There was a trend for a higher SVR in Caucasians than in Blacks. In multivariate analysis, the only predictors for SVR were the presence of cirrhosis, HCV viral load, age < 40 vs > or = 40 yrs, and treatment status (relapsers vs naive).
G4 patients in Belgium have the same SVR as G1 patients. It is lower than the SVR described in Arab countries, especially for Black G4 patients.
中东地区的4型(G4)慢性丙型肝炎患者对治疗的反应比1型(G1)患者更好。关于居住在西欧的G4患者的治疗反应率的数据较少。比利时的许多G4患者来自中非,他们对治疗的反应似乎较低。
我们分析了在比利时进行的两项随机III期研究BerNar-1和BerNar-2的数据,比较了78例G4患者(34例白种人,44例黑人)和477例G1患者(455例白种人,12例黑人)接受聚乙二醇干扰素和利巴韦林治疗后的持续病毒学应答(SVR),并评估了SVR的预测因素。
G4和G1患者的基线特征相似,主要区别在于种族。G4患者(73.2%)和G1患者(68.1%)的完全早期病毒学应答(cEVR)相似。黑人与白人G4患者以及黑人与白人G1患者之间的cEVR也相似。G4和G1的部分早期病毒学应答相似。G4患者(51.3%)和G1患者(51.8%)的SVR相似。白种人的SVR有高于黑人的趋势。在多变量分析中,SVR的唯一预测因素是肝硬化的存在、HCV病毒载量、年龄<40岁与≥40岁,以及治疗状态(复发者与初治者)。
比利时的G4患者与G1患者的SVR相同。它低于阿拉伯国家描述的SVR,尤其是对于黑人G4患者。