Factors that effect on therapeutic treatment with Pegylated interferon alpha and ribavirin in genotype 3 Hepatitis C virus patients at Phetchabun Hospital.
Keywords:
hepatitis C patients genotype 3, sustained virological response, Risk factorsAbstract
Background: Chronic hepatitis C is a major public health problems and leading cause of chronic liver disease. The currently recommended treatment for chronic hepatitis C is Pegylated Interferon alpha and ribavirin.
Objective: To determined predictive factors that effected to sustained virological response (SVR) in patients who treatmented with Pegylated Interferon alpha and ribavirin, genotype 3 in Phetchabun Hospital.
Methods: A retrospective study reviewed chronic hepatitis C patients genotype 3 in MaharajPhetchabun Hospitalfrom January 2015 to December 2017. Predictive factors include dermographic factors, virological factors, biochemistry factors, histopathological factors, pharmacological factors and viral kinetic factors were analysed.
Result: 176 patients with chronic hepatitis C genotype 3. The SVR rate in genotype 3 were 79.55%. Univariate analysis for predictive factors that effected to SVR were BMI < 25 kg/mm2 low baseline viral load < 400,000 IU/ml and ETR (end of treatment response) (p.012,.000,.014 respectively). In multivariable analysis, factors that effected to SVR was BMI < 25 kg/mm2 (OR 3.204, 95% CI 1.360-7.548, P.008) low baseline viral load < 400,000 IU/ml (OR 8.946, 95% CI 2.454-32.614, P.001) serum albumin ≥ 3.5 g/dl (OR 2.833, 95% CI 1.180-6.799, P.02)
Conclusions: Patients with chronic hepatitis C who BMI less than 25 kg/mm2,lowbaseline viral load and high serum albumin are the good predictors for the treatment response.
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circulation of hepatitis C virus geno types. World journal of gastroenterology 2016;22(34):7824-40.
Chimparlee N, Oota S, Phikulsod S, Tangkijvanich P, Poovorawan Y. Hepatitis B and hepatitis C virus in Thai blood donors. Southeast Asian J Trop Med Public Health 2011;42(3):609-15.
Mohd Hanafiah K, Groeger J, Flaxman AD, Wiersma ST. Global epidemiology of hepatitis C virus infection: new esti mates of age-specific antibody to HCV
seroprevalence. Hepatology 2013; 57(4):1333-42.
Akuta N, Suzuki F, Kawamura Y, Yatsuji H, Sezaki H, Suzuki Y, et al. Predictive factors of early and sustained responses to peginterferon plus ribavirin combi
nationtherapy in Japanese patients infected with hepatitis C virus genotype 1b: amino acid substitutions in the core region and low-density lipoprotein cholesterol levels. J Hepatol 2007; 46(3):403-10.
Marcellin P, Asselah T, Boyer N. Fibrosis and disease progression in hepatitis C. Hepatology 2002;36(5 Suppl 1):S47-56.
Yano M, Kumada H, Kage M, Ikeda K, Shimamatsu K, Inoue O, et al. The long-term pathological evolution of chronic hepatitis C. Hepatology 1996;23(6):1334-40.
Ghany MG, Strader DB, Thomas DL, Seeff LB. Diagnosis, management, and treatment of hepatitis C: an update. Hepatology 2009;49(4):1335-74.
สมาคมโรคตับแห่งประเทศไทย. แนวทางการดูแลรักษาผู้ป่วยไวรัสตับอักเสบซีเรื้อรังในประเทศไทยปีพ.ศ. 2556 (Thailand Practice Guideline for Management of Chronic Hepatitis C 2015) 2015(1): 34-74.
สมาคมโรคตับแห่งประเทศไทย. แนวทางการรักษาไวรัสตับอักเสบซีของสมาคมโรคตับแห่งประเทศไทยปีพ.ศ. 2555 (Thailand Practice Guideline for Management of Chronic Hepatitis C 2012) 2012(2):30-52.
สมาคมโรคตับแห่งประเทศไทย. แนวทางการรักษาไวรัสตับอักเสบซีของสมาคมโรคตับแห่งประเทศไทยปีพ.ศ. 2561 (Thailand Practice Guideline for Management of Chronic Hepatitis C 2017) 2017 (1):1-34.
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C: a randomized study of treatment duration and ribavirin dose. Ann Intern Med 2004;140(5):346-55.
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Liu CJ, Chuang WL, Lee CM, Yu ML, Lu SN, Wu SS, et al. Peginterferon alfa-2a plus ribavirin for the treatment of dual chronic infection with hepatitis B and C viruses. Gastroenterology 2009;136(2):496-504.e3.
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Lee H, Choi MS, Paik SW, Kim JH, Kim DY, Lee JH, et al. [Peginterferon alfa-2a plus ribavirin for initial treatment of chronic hepatitis C in Korea]. The Korean journal of hepatology 2006;12(1):31-40.
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Shiffman ML, Suter F, Bacon BR, Nelson D, Harley H, Sola R, et al. Peginterferon alfa-2a and ribavirin for 16 or 24 weeks in HCV genotype 2 or 3. The New England journal of medicine 2007;357(2):124-34.
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Yu ML, Chuang WL. Treatment of chronic hepatitis C in Asia: when East meets West. Journal of gastroen terology and hepatology 2009; 24(3):336-45.
Asselah T, Thompson AJ, Flisiak R, Romero-Gomez M, Messinger D, Bakalos G, et al. A Predictive Model for Selecting Patients with HCV Geno type 3 Chronic Infection with a High Probability of Sustained Virological Response to Peginterferon Alfa-2a/ Ribavirin. PloS one 2016;11(3): e0150569.
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Duarte-Rojo A, Heathcote EJ, Feld JJ. ‘Easy to treat’ genotypes were not created equal: can rapid virological response (RVR) level the playing field? Journal of hepatology 2011;55(2): 466-73.
Alsio A, Rembeck K, Askarieh G, Christensen PB, Farkkila M, Langeland N, et al. Impact of obesity on the bioavailability of peginterferonalpha2a and ribavirin and treatment outcome for chronic hepatitis C genotype 2 or 3. PloS one 2012;7(5):e37521.
Chowdhury A, Santra A, Chaudhuri S,Dhali GK, Chaudhuri S, Maity SG, et al. Hepatitis C virus infection in the general population: a community -based study in West Bengal, India. Hepatology 2003;37(4):802-9.
Poynard T, Ratziu V, McHutchison J, Manns M, Goodman Z, Zeuzem S, et al. Effect of treatment with peginter feron or interferon alfa-2b and ribavirin on steatosis in patients infected with hepatitis C. Hepatology 2003;38(1): 75-85.
Berg T, Sarrazin C, Herrmann E, Hinrichsen H, Gerlach T, Zachoval R, et al. Prediction of treatment outcome in patients with chronic hepatitis C: significance of baseline parameters and viral dynamics during therapy. Hepatology 2003;37(3):600-9.
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Berg T, von Wagner M, Nasser S, Sarrazin C, Heintges T, Gerlach T, et al. Extended treatment duration for hepatitis C virus type 1: comparing 48 versus 72 weeks of peginterferon-alfa-2a plus ribavirin. Gastroenterology 2006;130(4):1086-97.
Jacobson IM, Brown RS, Jr., Freilich B, Afdhal N, Kwo PY, Santoro J, et al. Peginterferon alfa-2b and weightbased or flat-dose ribavirin in chronic hepatitis C patients: a randomized trial. Hepatology 2007;46(4):971-81.
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Aziz H, Raza A, Waheed Y, Gill U, Gill ML. Analysis of variables and interactions among variables associated with a sustained virological response to pegylated interferon alfa-2a plus ribavirin in hepatitis C virus genotype 3-infected patients. International journal of infectious diseases : IJID :official publication of the International
Society for Infectious Diseases 2012;16(8):e597-602.
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ElHefnawi MM, Zada S, El-Azab IA. Prediction of prognostic biomarkers for interferon-based therapy to hepatitis C virus patients: a meta-analysis of the NS5A protein in subtypes 1a, 1b, and 3a. Virology journal 2010;7:130.
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Shoeb D, Rowe IA, Freshwater D, Mutimer D, Brown A, Moreea S, et al. Response to antiviral therapy in patients with genotype 3 chronic hepatitis C: fibrosis but not race encourages relapse. European journal of gastroenterology & hepatology 2011;23(9):747-53.
Aghemo A, Rumi MG, Soffredini R, D’Ambrosio R, Ronchi G, Del Ninno E, et al. Impaired response to interferon-alpha2b plus ribavirin in cirrhotic patients with genotype 3a hepatitis C virus infection. Antiviral therapy 2006; 11(6):797-802.
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circulation of hepatitis C virus geno types. World journal of gastroenterology 2016;22(34):7824-40.
Chimparlee N, Oota S, Phikulsod S, Tangkijvanich P, Poovorawan Y. Hepatitis B and hepatitis C virus in Thai blood donors. Southeast Asian J Trop Med Public Health 2011;42(3):609-15.
Mohd Hanafiah K, Groeger J, Flaxman AD, Wiersma ST. Global epidemiology of hepatitis C virus infection: new esti mates of age-specific antibody to HCV
seroprevalence. Hepatology 2013; 57(4):1333-42.
Akuta N, Suzuki F, Kawamura Y, Yatsuji H, Sezaki H, Suzuki Y, et al. Predictive factors of early and sustained responses to peginterferon plus ribavirin combi
nationtherapy in Japanese patients infected with hepatitis C virus genotype 1b: amino acid substitutions in the core region and low-density lipoprotein cholesterol levels. J Hepatol 2007; 46(3):403-10.
Marcellin P, Asselah T, Boyer N. Fibrosis and disease progression in hepatitis C. Hepatology 2002;36(5 Suppl 1):S47-56.
Yano M, Kumada H, Kage M, Ikeda K, Shimamatsu K, Inoue O, et al. The long-term pathological evolution of chronic hepatitis C. Hepatology 1996;23(6):1334-40.
Ghany MG, Strader DB, Thomas DL, Seeff LB. Diagnosis, management, and treatment of hepatitis C: an update. Hepatology 2009;49(4):1335-74.
สมาคมโรคตับแห่งประเทศไทย. แนวทางการดูแลรักษาผู้ป่วยไวรัสตับอักเสบซีเรื้อรังในประเทศไทยปีพ.ศ. 2556 (Thailand Practice Guideline for Management of Chronic Hepatitis C 2015) 2015(1): 34-74.
สมาคมโรคตับแห่งประเทศไทย. แนวทางการรักษาไวรัสตับอักเสบซีของสมาคมโรคตับแห่งประเทศไทยปีพ.ศ. 2555 (Thailand Practice Guideline for Management of Chronic Hepatitis C 2012) 2012(2):30-52.
สมาคมโรคตับแห่งประเทศไทย. แนวทางการรักษาไวรัสตับอักเสบซีของสมาคมโรคตับแห่งประเทศไทยปีพ.ศ. 2561 (Thailand Practice Guideline for Management of Chronic Hepatitis C 2017) 2017 (1):1-34.
Lo Re V, 3rd, Kostman JR. Management of chronic hepatitis C. Post graduate medical journal 2005; 81 (956):376-82.
Manns MP, McHutchison JG, Gordon SC, Rustgi VK, Shiffman M, Reindollar R, et al. Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Lancet (London, England) 2001;358(9286):958-65.
Fried MW, Shiffman ML, Reddy KR, Smith C, Marinos G, Goncales FL, Jr., et al. Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection.
The New England journal of medicine 2002;347(13):975-82.
Hadziyannis SJ, Sette H, Jr., Morgan TR, Balan V, Diago M, Marcellin P, et al. Peginterferon-alpha2a and ribavirin combination therapy in chronic hepatitis
C: a randomized study of treatment duration and ribavirin dose. Ann Intern Med 2004;140(5):346-55.
Zeuzem S, Rodriguez-Torres M, Rajender Reddy K, Marcellin P, Diago M, Craxi A, et al. Optimized threshold for serum HCV RNA to predict treat ment outcomes in hepatitis C patients receiving peginterferon alfa-2a/ ribavirin. Journal of viral hepatitis 2012;19(11):766-74.
Von Wagner M, Huber M, Berg T, Hinrichsen H, Rasenack J, Heintges T, et al. Peginterferon-alpha-2a (40KD) and ribavirin for 16 or 24 weeks in patients with genotype 2 or 3 chronic hepatitis C. Gastroenterology 2005; 129(2):522-7.
Liu CJ, Chuang WL, Lee CM, Yu ML, Lu SN, Wu SS, et al. Peginterferon alfa-2a plus ribavirin for the treatment of dual chronic infection with hepatitis B and C viruses. Gastroenterology 2009;136(2):496-504.e3.
Lee HJ, Eun JR, Choi JW, Kim KO, Moon HJ. [Comparison of therapeutic results between combination therapy of peginterferon alpha-2a plus ribavirin and interferon alpha-2b plus ribavirin according to treatment duration in patients with chronic hepatitis C]. The Korean journal of hepatology 2008; 14(1):46-57.
Lee H, Choi MS, Paik SW, Kim JH, Kim DY, Lee JH, et al. [Peginterferon alfa-2a plus ribavirin for initial treatment of chronic hepatitis C in Korea]. The Korean journal of hepatology 2006;12(1):31-40.
Kim KT, Han SY, Kim JH, Yoon HA, Baek YH, Kim MJ, et al. [Clinical outcome of pegylated interferon and ribavirin therapy for chronic hepatitis C]. The Korean journal of hepatology 2008;14(1):36-45.
Poynard T, McHutchison J, Goodman Z, Ling MH, Albrecht J. Is an “a lacarte” combination interferon alfa-2b plus ribavirin regimen possible for the first line treatment in patients with chronic hepatitis C? The ALGO VIRC Project Group. Hepatology 2000;31(1):211-8.
Shiffman ML, Suter F, Bacon BR, Nelson D, Harley H, Sola R, et al. Peginterferon alfa-2a and ribavirin for 16 or 24 weeks in HCV genotype 2 or 3. The New England journal of medicine 2007;357(2):124-34.
Liu CH, Liu CJ, Lin CL, Liang CC, Hsu SJ, Yang SS, et al. Pegylated inter feron-alpha-2a plus ribavirin for treatment-naive Asian patients with hepatitis C virus genotype 1 infection: a multicenter, randomized controlled trial. Clin Infect Dis 2008;47(10):1260-9.
Yu ML, Chuang WL. Treatment of chronic hepatitis C in Asia: when East meets West. Journal of gastroen terology and hepatology 2009; 24(3):336-45.
Asselah T, Thompson AJ, Flisiak R, Romero-Gomez M, Messinger D, Bakalos G, et al. A Predictive Model for Selecting Patients with HCV Geno type 3 Chronic Infection with a High Probability of Sustained Virological Response to Peginterferon Alfa-2a/ Ribavirin. PloS one 2016;11(3): e0150569.
Vasudevan S, Kavimandan A, Kalra N, Nayak B, Thakur B, Das P, et al. Demographic profile, host, disease & viral predictive factors of response in patients with chronic hepatitis C virus infection at a tertiary care hospital in north India. The Indian journal of medical research 2016; 143(3):331-40.
Duarte-Rojo A, Heathcote EJ, Feld JJ. ‘Easy to treat’ genotypes were not created equal: can rapid virological response (RVR) level the playing field? Journal of hepatology 2011;55(2): 466-73.
Alsio A, Rembeck K, Askarieh G, Christensen PB, Farkkila M, Langeland N, et al. Impact of obesity on the bioavailability of peginterferonalpha2a and ribavirin and treatment outcome for chronic hepatitis C genotype 2 or 3. PloS one 2012;7(5):e37521.
Chowdhury A, Santra A, Chaudhuri S,Dhali GK, Chaudhuri S, Maity SG, et al. Hepatitis C virus infection in the general population: a community -based study in West Bengal, India. Hepatology 2003;37(4):802-9.
Poynard T, Ratziu V, McHutchison J, Manns M, Goodman Z, Zeuzem S, et al. Effect of treatment with peginter feron or interferon alfa-2b and ribavirin on steatosis in patients infected with hepatitis C. Hepatology 2003;38(1): 75-85.
Berg T, Sarrazin C, Herrmann E, Hinrichsen H, Gerlach T, Zachoval R, et al. Prediction of treatment outcome in patients with chronic hepatitis C: significance of baseline parameters and viral dynamics during therapy. Hepatology 2003;37(3):600-9.
Zeuzem S, Hultcrantz R, Bourliere M, Goeser T, Marcellin P, Sanchez-Tapias J, et al. Peginterferon alfa-2b plus ribavirin for treatment of chronic hepatitis C in previously untreated patients infected with HCV genotypes 2 or 3. J Hepatol 2004;40(6):993-9.
Berg T, von Wagner M, Nasser S, Sarrazin C, Heintges T, Gerlach T, et al. Extended treatment duration for hepatitis C virus type 1: comparing 48 versus 72 weeks of peginterferon-alfa-2a plus ribavirin. Gastroenterology 2006;130(4):1086-97.
Jacobson IM, Brown RS, Jr., Freilich B, Afdhal N, Kwo PY, Santoro J, et al. Peginterferon alfa-2b and weightbased or flat-dose ribavirin in chronic hepatitis C patients: a randomized trial. Hepatology 2007;46(4):971-81.
Zeuzem S, Buti M, Ferenci P, Sperl J, Horsmans Y, Cianciara J, et al. Efficacy of 24 weeks treatment with peginterferon alfa-2b plus ribavirin in patients with chronic hepatitis C infected with genotype 1 and low pretreatment viremia. J Hepatol 2006;44(1):97-103.
Aziz H, Raza A, Waheed Y, Gill U, Gill ML. Analysis of variables and interactions among variables associated with a sustained virological response to pegylated interferon alfa-2a plus ribavirin in hepatitis C virus genotype 3-infected patients. International journal of infectious diseases : IJID :official publication of the International
Society for Infectious Diseases 2012;16(8):e597-602.
El-Shamy A, Hotta H. Impact of hepatitis C virus heterogeneity on interferon sensitivity: an overview. World journal of gastroenterology 2014;20(24):7555-69.
ElHefnawi MM, Zada S, El-Azab IA. Prediction of prognostic biomarkers for interferon-based therapy to hepatitis C virus patients: a meta-analysis of the NS5A protein in subtypes 1a, 1b, and 3a. Virology journal 2010;7:130.
Hlaing NK, Banerjee D, Mitrani R, Arker SH, Win KS, Tun NL, et al. Hepatitis C virus therapy with peg-interferon and ribavirin in Myanmar: A resource-constrained country. World journal of gastroenterology 2016;22(43):9613-22.
Garcia-Martinez R, Caraceni P, Bernardi M, Gines P, Arroyo V, Jalan R. Albumin: pathophysiologic basis of its role in the treatment of cirrhosis and its complications. Hepatology 2013; 58(5):1836-46.
Shoeb D, Rowe IA, Freshwater D, Mutimer D, Brown A, Moreea S, et al. Response to antiviral therapy in patients with genotype 3 chronic hepatitis C: fibrosis but not race encourages relapse. European journal of gastroenterology & hepatology 2011;23(9):747-53.
Aghemo A, Rumi MG, Soffredini R, D’Ambrosio R, Ronchi G, Del Ninno E, et al. Impaired response to interferon-alpha2b plus ribavirin in cirrhotic patients with genotype 3a hepatitis C virus infection. Antiviral therapy 2006; 11(6):797-802.
Jensen DM, Morgan TR, Marcellin P, Pockros PJ, Reddy KR, Hadziyannis SJ, et al. Early identification of HCV genotype 1 patients responding to 24 weeks peginterferon alpha-2a (40 kd)/ribavirin therapy. Hepatology 2006;43(5):954-60.
Niederau C, Mauss S, Schober A, Stoehr A, Zimmermann T, Waizmann M, et al. Predictive factors for sustained virological response after treatment with pegylated interferon alpha-2a and ribavirin in patients infected with HCV genotypes 2 and 3. PloS one 2014;9(9):e107592.
Wu CK, Chang KC, Tseng PL, Lu SN, Chen CH, Wang JH, et al. Com parison of Therapeutic Response and Clinical Outcome between HCV Patients with Normal and Abnormal Alanine Transaminase Levels. PloS one 2016;11(3):e0142378.
Sarwar S, Butt AK, Khan AA, Alam A, Ahmad I, Dilshad A. Serum alanine aminotransferase level and response to interferon-ribavirin combination therapy in patients with chronic hepatitis C. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP 2006;16(7):460-3.
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Published
2019-05-09
How to Cite
พั้วช่วย โ. (2019). Factors that effect on therapeutic treatment with Pegylated interferon alpha and ribavirin in genotype 3 Hepatitis C virus patients at Phetchabun Hospital. Region 11 Medical Journal, 33(1), 19–34. Retrieved from https://he02.tci-thaijo.org/index.php/Reg11MedJ/article/view/188122
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