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HCV genotype 1a shows a better virological response to antiviral therapy than HCV genotype 1b.

Pellicelli AM, Romano M, Stroffolini T, Mazzoni E, Mecenate F, Monarca R, Picardi A, Bonaventura ME, Mastropietro C, Vignally P, Andreoli A, Marignani M, D'Ambrosio C, Miglioresi L, Nosotti L, Mitidieri O, Gentilucci UV, Puoti C, Barbaro G, Barlattani A, Furlan C, Barbarini G, CLEO Gro - BMC Gastroenterol (2012)

Bottom Line: The numbers of patients in whom HCV-RNA was undetectable were compared after 4 (rapid virological response, RVR), 12 (early virological response, EVR), and 48 (end treatment virological response, ETR) weeks of treatment as well as 24 weeks after the last treatment (sustained virological response, SVR).The rate of SVR was higher in subtype 1a patients than subtype 1b patients (55% vs. 43%; p < 0.02).Dual antiviral therapy is more effective against HCV subtype 1a than against subtype 1b and this difference is independent of other factors that may favour viral clearance.

View Article: PubMed Central - HTML - PubMed

Affiliation: Liver Unit Azienda Ospedaliera San Camillo Forlanini, Circonvallazione Gianicolense, 87 00149, Rome, Italy. adriano.pellicelli@tiscali.it.

ABSTRACT

Background: The impact of viral subtype on the rate of sustained virological response (SVR) to antiviral therapy in patients chronically infected with hepatitis C genotype 1 subtype 1a and 1b has not been extensively investigated. The aim of this study is to determine whether the HCV genotype 1 subtypes 1a and 1b respond differently to treatment with PEGylated interferon (PEG-IFN) plus ribavirin.

Methods: For 48 weeks, 388 "naïve"genotype 1 patients were treated weekly with PEG-IFN α-2a or PEG-INF α-2b combined with daily ribavirin (1000-1200 mg/day). The numbers of patients in whom HCV-RNA was undetectable were compared after 4 (rapid virological response, RVR), 12 (early virological response, EVR), and 48 (end treatment virological response, ETR) weeks of treatment as well as 24 weeks after the last treatment (sustained virological response, SVR).

Results: The rate of SVR was higher in subtype 1a patients than subtype 1b patients (55% vs. 43%; p < 0.02). Multiple logistic regression analysis showed that infection with genotype 1a (odds ratio(OR) : 1.8; 95% confidence interval (CI): 1.4 to 4.1), age < 50 years (OR:7.0; 95% CI 1.1 to 21.2), alanine aminotransferase level (ALT)<100 IU/ml (OR:2.1; 95% CI: 1.3 to3.5), HCV-RNA < 5.6 log10 IU/ml (OR: 3.2; 95% CI: 2.7 to 6.9) and fibrosis score < S3 (OR: 3.8; 95% CI:3.2 to 7.4), were all independent predictors of SVR.

Conclusion: Dual antiviral therapy is more effective against HCV subtype 1a than against subtype 1b and this difference is independent of other factors that may favour viral clearance.

Trial registration: ClinicalTrials.gov Identifier: NCT01342003.

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Rapid virological response (RVR), early virological response (EVR), end treatment virological response (ETR), sustained virological response (SVR) and drop out in genotype 1 subtypes 1a and 1b patients.
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Figure 1: Rapid virological response (RVR), early virological response (EVR), end treatment virological response (ETR), sustained virological response (SVR) and drop out in genotype 1 subtypes 1a and 1b patients.

Mentions: At week 4 of treatment HCV-RNA was undetectable (RVR) in 77 genotype 1a patients (47%) and in 83 genotype 1b patients (37%) ( p < 0.07). At week 12 of treatment 91 genotype 1a patients (55%) and 99 genotype 1b patients (44%) had undetectable HCV-RNA (early virological response; EVR) (p < 0.04). At the end of treatment 108 genotype 1a patients (65%) and 131 genotype 1b patients (58%) had undetectable HCV-RNA (p = n.s). Seventeen (10%) of the genotype 1a patients and 32 (14%) of the genotype 1b had detectable HCVRNA at week 12 but not at week 24 (slow responders) (p = ns).At the end of the treatment, there were 16 (9%) relapsed patients in the genotype 1a group and 35(15%) in the genotype 1b group (p = ns). Sustained virological response was attained in 91 genotype 1a patients (55%) and 96 genotype 1b patients (43%) ( p < 0.02). A total of 18 genotype 1a and 16 genotype 1b patients discontinued all treatments at some time during the study owing due adverse events (Figure 1).


HCV genotype 1a shows a better virological response to antiviral therapy than HCV genotype 1b.

Pellicelli AM, Romano M, Stroffolini T, Mazzoni E, Mecenate F, Monarca R, Picardi A, Bonaventura ME, Mastropietro C, Vignally P, Andreoli A, Marignani M, D'Ambrosio C, Miglioresi L, Nosotti L, Mitidieri O, Gentilucci UV, Puoti C, Barbaro G, Barlattani A, Furlan C, Barbarini G, CLEO Gro - BMC Gastroenterol (2012)

Rapid virological response (RVR), early virological response (EVR), end treatment virological response (ETR), sustained virological response (SVR) and drop out in genotype 1 subtypes 1a and 1b patients.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3526494&req=5

Figure 1: Rapid virological response (RVR), early virological response (EVR), end treatment virological response (ETR), sustained virological response (SVR) and drop out in genotype 1 subtypes 1a and 1b patients.
Mentions: At week 4 of treatment HCV-RNA was undetectable (RVR) in 77 genotype 1a patients (47%) and in 83 genotype 1b patients (37%) ( p < 0.07). At week 12 of treatment 91 genotype 1a patients (55%) and 99 genotype 1b patients (44%) had undetectable HCV-RNA (early virological response; EVR) (p < 0.04). At the end of treatment 108 genotype 1a patients (65%) and 131 genotype 1b patients (58%) had undetectable HCV-RNA (p = n.s). Seventeen (10%) of the genotype 1a patients and 32 (14%) of the genotype 1b had detectable HCVRNA at week 12 but not at week 24 (slow responders) (p = ns).At the end of the treatment, there were 16 (9%) relapsed patients in the genotype 1a group and 35(15%) in the genotype 1b group (p = ns). Sustained virological response was attained in 91 genotype 1a patients (55%) and 96 genotype 1b patients (43%) ( p < 0.02). A total of 18 genotype 1a and 16 genotype 1b patients discontinued all treatments at some time during the study owing due adverse events (Figure 1).

Bottom Line: The numbers of patients in whom HCV-RNA was undetectable were compared after 4 (rapid virological response, RVR), 12 (early virological response, EVR), and 48 (end treatment virological response, ETR) weeks of treatment as well as 24 weeks after the last treatment (sustained virological response, SVR).The rate of SVR was higher in subtype 1a patients than subtype 1b patients (55% vs. 43%; p < 0.02).Dual antiviral therapy is more effective against HCV subtype 1a than against subtype 1b and this difference is independent of other factors that may favour viral clearance.

View Article: PubMed Central - HTML - PubMed

Affiliation: Liver Unit Azienda Ospedaliera San Camillo Forlanini, Circonvallazione Gianicolense, 87 00149, Rome, Italy. adriano.pellicelli@tiscali.it.

ABSTRACT

Background: The impact of viral subtype on the rate of sustained virological response (SVR) to antiviral therapy in patients chronically infected with hepatitis C genotype 1 subtype 1a and 1b has not been extensively investigated. The aim of this study is to determine whether the HCV genotype 1 subtypes 1a and 1b respond differently to treatment with PEGylated interferon (PEG-IFN) plus ribavirin.

Methods: For 48 weeks, 388 "naïve"genotype 1 patients were treated weekly with PEG-IFN α-2a or PEG-INF α-2b combined with daily ribavirin (1000-1200 mg/day). The numbers of patients in whom HCV-RNA was undetectable were compared after 4 (rapid virological response, RVR), 12 (early virological response, EVR), and 48 (end treatment virological response, ETR) weeks of treatment as well as 24 weeks after the last treatment (sustained virological response, SVR).

Results: The rate of SVR was higher in subtype 1a patients than subtype 1b patients (55% vs. 43%; p < 0.02). Multiple logistic regression analysis showed that infection with genotype 1a (odds ratio(OR) : 1.8; 95% confidence interval (CI): 1.4 to 4.1), age < 50 years (OR:7.0; 95% CI 1.1 to 21.2), alanine aminotransferase level (ALT)<100 IU/ml (OR:2.1; 95% CI: 1.3 to3.5), HCV-RNA < 5.6 log10 IU/ml (OR: 3.2; 95% CI: 2.7 to 6.9) and fibrosis score < S3 (OR: 3.8; 95% CI:3.2 to 7.4), were all independent predictors of SVR.

Conclusion: Dual antiviral therapy is more effective against HCV subtype 1a than against subtype 1b and this difference is independent of other factors that may favour viral clearance.

Trial registration: ClinicalTrials.gov Identifier: NCT01342003.

Show MeSH
Related in: MedlinePlus