Impact of selected predictive factors on sustained virologic response in HCV genotype 4 infected patients treated with pegylated interferon alpha and ribavirin.

BACKGROUND

Dual therapy (PegIFN and ribavirin) (DT) had been the standard of care in patients infected with HCV genotype 4 (HCV-4) until 2014. Thereafter, new treatment options were available including IFNbased and other IFN-free regimens.

OBJECTIVES

The aim was to assess the efficacy (SVR24) of DT and a selection of predictive factors of SVR in HCV-4 infected patients.

METHODS

112 patients (62 men) of median age 23 years were treated with DT for 48/72 weeks (107/5). Most of them were treatment naïve (80.4%) and with fibrosis F≤2(83.1%). Individuals with prior hepatitis B virus (HBV) infection, i.e. positive antibodies to the hepatitis B core antigen (anti-HBc), negative hepatitis B surface antigen and undetectable serum HBV DNA were included into the analysis.

RESULTS

SVR24 was achieved in 46/112(41.1%) patients. Null response (NR) was recognized in 24.1%, partial response in 13.4%, relapse in 10.7% and breakthrough in 6.2% of patients. SVR24 was associated with lack of previous treatment experience, younger age (<40 years), pretreatment viral load <2x105 IU/ml, less advanced fibrosis (F≤2) and >10% loss of baseline weight. Anti-HBc was detected in 25(22.3%) patients out of which four (16%) achieved SVR24 in comparison to 42(48.8%) patients with anti-HBc negative (p<0.005); NR was observed in 10(40%) individuals vs 17(19.8%) in anti-HBc negative patients.

CONCLUSIONS

SVR24 was low. The age <40 years, less advanced fibrosis, pretreatment viral load <2x105 IU/ml, lack of previous treatment experience, loss of body weight were the positive predictive factors of SVR24. Prior HBV infection correlated with poorer SVR24 and NR.