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Multicenter Study
. 2014 Jan-Feb;18(1):48-52.
doi: 10.1016/j.bjid.2013.05.007. Epub 2013 Sep 20.

Peginterferon plus ribavirin and sustained virological response rate in HCV-related advanced fibrosis: a real life study

Giovanni Faria Silva  1 , Cristiane A Villela-Nogueira  2 , Carlos Eduardo Brandão Mello  2 , Elza Cotrim Soares  3 , Henrique Sergio M Coelho  2 , Paulo Roberto Abrão Ferreira  4 , Fernando José Goes Ruiz  5 ; Brazilian HCV-Related Advanced Fibrosis Study Group
Collaborators, Affiliations
Multicenter Study

Peginterferon plus ribavirin and sustained virological response rate in HCV-related advanced fibrosis: a real life study

Giovanni Faria Silva et al. Braz J Infect Dis. 2014 Jan-Feb.

Abstract

Background: Tolerance and response to antiviral HCV treatment is poor in advanced fibrosis. The aim of this study was to assess SVR rate and its predictive factors in HCV advanced fibrosis patients treated in real life with full dose PEG-IFN plus RBV and to evaluate the adverse events related to treatment.

Methods: A multicentric, retrospective study was conducted at six university hospitals. METAVIR F3 and F4 HCV monoinfected patients who were treated with PEG-IFN and RBV had their data analyzed. A stepwise logistic regression analysis was performed to identify the variables independently related to SVR. Adverse events were recorded during treatment.

Results: 308 patients were included, 75% genotype 1 and 23% genotype 3. METAVIR F3 was present in 39% and F4 in 61% of patients. The median Child Pugh score for F4 patients was 5 (5-9). The global SVR rate was 34%, 11% were relapsers and 55% were nonresponders. SVR rates were similar between patients treated with PEG-IFN alfa 2a or alfa 2b (p=0.24). SVR rates according to Child-Pugh score were 26% (Child A) and 18% (Child B). The independent factors related to SVR in F4 patients were genotype 3, RVR and fewer Child Pugh score points. Treatment interruption occurred in 31% patients and death occurred in 1.9%, all with liver cirrhosis.

Conclusion: Treatment of HCV in patients with advanced fibrosis should not be postponed. However, a very careful evaluation of cirrhotic patients must be performed before treatment is indicated and careful monitoring is required during treatment.

Keywords: Advanced fibrosis; Hepatitis C; Peginterferon; Ribavirin.

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