Changes in the response to treatment against chronic hepatitis C between 1999 and 2015: data from a prospective cohort. Issue 11 (November 2016)

• Record Type: Journal Article
• Authors: Mancebo, María; Real, Luis M.; Mira, José A.; Recio, Eva; Pérez, Elisabet; Monje-Agudo, Patricia; Merchante, Nicolás; Macías, Juan; Neukam, Karin; Pineda, Juan A.
• Is Part Of: European journal of gastroenterology & hepatology. Volume 28:Issue 11(2016:Nov.)
• Publication Date: 2016-11
• Subjects: direct-acting antivirals -- hepatitis C virus -- HIV -- interleukin 28B -- pegylated interferon -- ribavirin -- sustained virologic response -- nonresponse; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Digestive organs -- Diseases; Liver -- Diseases; Periodicals; 616.33
• DOI: 10.1097/MEG.0000000000000705
• Languages: English
• ISSNs: 0954-691X

Abstract

Abstract : Background: The drug options and strategies for treatment against hepatitis C virus (HCV) infection have changed considerably in the last few years. The aim of this study was to compare the changes in the proportion of nonresponders and patients who achieved a sustained virologic response (SVR) from 1999 to 2015 in one single cohort. Patients and methods: A total of 522 patients treated against chronic hepatitis C were included prospectively. The time periods were 1999–2002 [interferon (IFN)/ribavirin (RBV)], 2002–2009 (pegylated-IFN/RBV), 2010–2011 (use of IL28B genotype), 2012–2014 (pegylated-IFN/RBV/direct-acting antivirals) and 2015 (IFN-free direct-acting antiviral-based therapy). Results: The numbers of nonresponders in the study periods in chronological order were as follows: 14 (40%), 76 (21.3%), 7 (8%), 10 (13%), and 0; P =1.1×10 –7 and r 2 =0.837. The corresponding numbers of patients who achieved SVR were 9 (25.7%), 14 (40.9%), 44 (50.6%), 51 (66.2%), and 64 (90.1%), P =3.3×10 –15 and r 2 =0.997. Characteristics that may impair SVR, such as advanced fibrosis, genotype 1 infection, HIV coinfection, or treatment experience, did not decrease in the last time periods. Conclusion: The proportion of nonresponders was significantly reduced using the IL28B genotype as a predictive tool and direct-acting antivirals further improved treatment outcome. Concomitantly, the rates of SVR showed a linear increase.