Advertisement

Irish Journal of Medical Science

, Volume 181, Issue 1, pp 53–58 | Cite as

Rapid, early and sustained virological responses in a cohort of Irish patients treated with pegylated interferon and ribavirin for chronic hepatitis C virus infection

  • S. Sarwar
  • E. J. Ryan
  • M. Iqbal
  • P. A. McCormick
  • C. O’Farrelly
  • J. Hegarty
Original Article

Abstract

Background

The response to the treatment with pegylated interferon (PEG IFN)-α combined with ribavirin in chronic hepatitis C virus (HCV) infection varies with some patients having a rapid or early response which is not sustained.

Aims

To investigate the rates of rapid virological response (RVR), early virological response (EVR) and sustained virological response (SVR) in an Irish cohort of HCV infected patients receiving IFN-α/ribavirin.

Methods

Rates of RVR, EVR and SVR were examined in 123 patients undergoing standard treatment for chronic HCV infection between 2001 and 2007 at a Dublin Teaching Hospital.

Results

The rates of RVR, EVR and SVR in genotype 1 patients were 48, 68 and 50%, while in genotype 2/3 patients they were 87, 93 and 87%, respectively. The positive predictive values (PPV) of RVR for SVR in genotype 1 and genotype 2/3 patients were 90 and 92.4%, respectively.

Conclusion

The rates of response to PEG IFN-α/ribavirin in Irish patients are consistent with other international reports. We support the regular monitoring of rapid and early virological response as a standard of care in treating chronic hepatitis C patients.

Keywords

Hepatitis C Rapid early and sustained virological responses Predictive value Early viral kinetics Pegylated interferon-α Ribavirin 

Abbreviations

RVR

Rapid virological response

EVR

Early virological response

ETR

End of treatment response

SVR

Sustained virological response

PPV

Positive predictive value

NPV

Negative predictive value

HCV

Hepatitis C virus

PEG IFN-α

Pegylated interferon-α

AST

Aspartate aminotransferase

ALT

Alanine aminotransferase

WCC

White cell count

Notes

Acknowledgments

The authors are grateful to all study participants. The Hepatitis C Clinical Nurse Specialists, Carol McNulty, Aileen Murphy and Sheila O’Toole are acknowledged for their help and support during data collection. The Health Research Board provided funding. This study was funded by a Translational Research Award from the Irish Health Research Board. Prof. Aiden Mc Cormick has received honoraria from Merk & Janssen Cilag.

Conflict of interest

None.

References

  1. 1.
    Lauer GM, Walker BD (2001) Hepatitis C virus infection. N Engl J Med 345(1):41–52PubMedCrossRefGoogle Scholar
  2. 2.
    Seeff LB (1997) Natural history of hepatitis C. Hepatology 26(3):21S–28SPubMedCrossRefGoogle Scholar
  3. 3.
    Craxì A, Flisiak R, Mondelli M, Peck-Radosavljevic M, Sarrazin C, Dusheiko G (2011) EASL clinical practice guidelines: management of hepatitis C virus infection. J Hepatol 55:245–264CrossRefGoogle Scholar
  4. 4.
    Craxi A, Licata A (2003) Clinical trial results of peginterferons in combination with ribavirin. Semin Liver Dis 23(1):35–46PubMedGoogle Scholar
  5. 5.
    Ghany MG, Strader DB, Thomas DL, Seeff LB (2009) Diagnosis, management, and treatment of hepatitis C: an update. Hepatology 49(4):1335–1374PubMedCrossRefGoogle Scholar
  6. 6.
    Zeuzem S, Lee JH, Franke A et al (1998) Quantification of the initial decline of serum hepatitis C virus RNA and response to interferon alfa. Hepatology 27(4):1149–1156PubMedCrossRefGoogle Scholar
  7. 7.
    Yu JW, Wang GQ, Sun LJ, Li XG, Li SC (2007) Predictive value of rapid virological response and early virological response on sustained virological response in HCV patients treated with pegylated interferon alpha-2a and ribavirin. J Gastroenterol Hepatol 22(6):832–836PubMedCrossRefGoogle Scholar
  8. 8.
    Li MH, Chen LJ, Qiu GH et al (2009) Prediction of sustained viral response to combinational therapy with interferon and ribavirin in chronic hepatitis C by rapid viral response. Zhonghua Gan Zang Bing Za Zhi 17(7):497–500PubMedGoogle Scholar
  9. 9.
    Davis GL, Wong JB, McHutchison JG et al (2003) Early virologic response to treatment with peginterferon alfa-2b plus ribavirin in patients with chronic hepatitis C. Hepatology 38(3):645–652PubMedCrossRefGoogle Scholar
  10. 10.
    Ishak K, Baptista A, Bianchi L et al (1995) Histological grading and staging of chronic hepatitis. J Hepatol 22(6):696–699PubMedCrossRefGoogle Scholar
  11. 11.
    Fried MW, Shiffman ML, Reddy KR et al (2002) Peginterferon alfa-2a plus ribavirin for chronic hepatitis C virus infection. N Engl J Med 347(13):975–982PubMedCrossRefGoogle Scholar
  12. 12.
    Fried MW, Hadziyannis SJ, Shiffman ML, Messinger D, Zeuzem S (2011) Rapid virological response is the most important predictor of sustained virological response across genotypes in patients with chronic hepatitis C virus infection. J Hepatol 55(1):69–75PubMedCrossRefGoogle Scholar
  13. 13.
    Manns MP, McHutchison JG, Gordon SC et al (2001) Peginterferon alfa-2b plus ribavirin compared with interferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomised trial. Lancet 358(9286):958–965PubMedCrossRefGoogle Scholar
  14. 14.
    Martinot-Peignoux M, Maylin S, Moucari R et al (2009) Virological response at 4 weeks to predict outcome of hepatitis C treatment with pegylated interferon and ribavirin. Antivir Ther 14(4):501–511PubMedGoogle Scholar
  15. 15.
    Ferenci P, Fried MW, Shiffman ML et al (2005) Predicting sustained virological responses in chronic hepatitis C patients treated with peginterferon alfa-2a (40 KD)/ribavirin. J Hepatol 43(3):425–433PubMedCrossRefGoogle Scholar
  16. 16.
    Ge D, Fellay J, Thompson AJ et al (2009) Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance. Nature 461(7262):399–401PubMedCrossRefGoogle Scholar

Copyright information

© Royal Academy of Medicine in Ireland 2011

Authors and Affiliations

  • S. Sarwar
    • 1
  • E. J. Ryan
    • 2
  • M. Iqbal
    • 1
  • P. A. McCormick
    • 1
  • C. O’Farrelly
    • 2
    • 3
  • J. Hegarty
    • 1
  1. 1.Liver UnitSt Vincent’s University HospitalDublin 4Ireland
  2. 2.School of Biochemistry and ImmunologyTrinity CollegeDublin 4Ireland
  3. 3.School of Biochemistry and Immunology and School of MedicineTrinity CollegeDublin 2Ireland

Personalised recommendations