Implications of rapid virological response in hepatitis C therapy in the US veteran population

Aliment Pharmacol Ther 2012; 35: 105–115 Summary Background  Early predictors of response to hepatitis C virus (HCV) therapy, such as rapid virological response, are valuable for the identification of patients with a higher likelihood of treatment success. Aim  To identify predictors of rapid virolo...

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Published in:Alimentary pharmacology & therapeutics 2012-01, Vol.35 (1), p.105-115
Main Authors: Hwang, E. W., Thomas, I.-C., Cheung, R., Backus, L. I.
Format: Article
Language:English
Subjects:
Alanine transaminase
Antiviral Agents - therapeutic use
Aspartate aminotransferase
Biological and medical sciences
Cohort Studies
Diabetes mellitus
Digestive system
Drug Therapy, Combination
Ethnic groups
Female
Ferritin
Gastroenterology. Liver. Pancreas. Abdomen
Genotype
Genotypes
Hepacivirus - drug effects
Hepacivirus - genetics
Hepacivirus - isolation & purification
Hepatitis C
Hepatitis C virus
Hepatitis C, Chronic - drug therapy
Hepatitis C, Chronic - virology
Human viral diseases
Humans
Infectious diseases
Interferon-alpha - therapeutic use
Lipoproteins (low density)
Liver transplantation
Male
Medical sciences
Middle Aged
Pharmacology. Drug treatments
Platelets
Polyethylene Glycols - therapeutic use
Predictive Value of Tests
Races
Recombinant Proteins - therapeutic use
Ribavirin
Ribavirin - therapeutic use
RNA
RNA, Viral - blood
Time Factors
Treatment Outcome
United States
Veterans
Viral diseases
Viral hepatitis
Viral Load
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Summary:Aliment Pharmacol Ther 2012; 35: 105–115 Summary Background  Early predictors of response to hepatitis C virus (HCV) therapy, such as rapid virological response, are valuable for the identification of patients with a higher likelihood of treatment success. Aim  To identify predictors of rapid virological response in a real world setting. Methods  Using the VA Clinical Case Registry, we identified patients with HCV mono‐infection, without liver transplantation, who initiated peginterferon (PEG‐IFN) and ribavirin (RBV) in 2007 or 2008 and had HCV RNA testing for RVR. Significant baseline characteristics from genotype specific univariate analyses were used in backwards stepwise models to identify significant independent predictors of RVR. Results  The final cohort consisted of 2424 patients with genotype 1 (G1), 666 patients with genotype 2 (G2), and 419 patients with genotype 3 (G3). Rapid virological response rates were 15% for G1, 71% for G2 and 57% for G3. Sustained virological response rates were significantly higher in patients with rapid virological response than without, increasing from 18% to 52% in G1, 39% to 71% in G2, and 40% to 60% in G3 (P 
ISSN:0269-2813
1365-2036
DOI:10.1111/j.1365-2036.2011.04903.x