Prediction of week 4 virological response in hepatitis C for making decision on triple therapy : the Optim study
Romero-Gómez, Manuel (Hospital Universitario Virgen de Valme (Sevilla, Andalusia))
Turnes, Juan (Complejo Hospitalario Universitario de Pontevedra)
Ampuero, Javier (Hospital Universitario Virgen de Valme (Sevilla, Andalusia))
Oyagüez, Itziar (Pharmacoeconomics & Outcomes Research IBeria (Madrid))
Cuenca, Beatriz (Hospital Universitario Infanta Cristina)
Gonzalez-García, Juan (Hospital Universitario La Paz (Madrid))
Muñoz-Molina, Belén (Roche Farma)
Aguilar, Rocío (Fisevi (Sevilla))
Leal, Sandra (Fisevi (Sevilla))
Planas Vilà, Ramon (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Garcia-Samaniego, Javier (Hospital Carlos III (Madrid))
Diago, Moises (Hospital General Universitario de Valencia)
Crespo García, Javier (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Calleja, Jose Luis (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Casado, Miguel Ángel (Pharmacoeconomics & Outcomes Research IBeria (Madrid))
Solà Lamoglia, Ricard (Hospital del Mar (Barcelona, Catalunya))

Data:	2015
Resum:	Background: Virological response to peginterferon + ribavirin (P+R) at week 4 can predict sustained virological response (SVR). While patients with rapid virological response (RVR) do not require triple therapy, patients with a decline <1log10 IU/ml HCVRNA (D1L) should have treatment discontinued due to low SVR rate. Aim: To develop a tool to predict first 4 weeks' viral response in patients with hepatitis C genotype 1&4 treated with P+R. Methods: In this prospective and multicenter study, HCV mono-infected (n=538) and HCV/HIV co-infected (n=186) patients were included. To develop and validate a prognostic tool to detect RVR and D1L, we segregated the patients as an estimation cohort (to construct the model) and a validation cohort (to validate the model). Results: D1L was reached in 509 (80. 2%) and RVR in 148 (22. 5%) patients. Multivariate analyses demonstrated that HIV co-infection, Forns' index, LVL, IL28B-CC and Genotype-1 were independently related to RVR as well as D1L. Diagnostic accuracy (AUROC) for D1L was: 0. 81 (95%CI: 0. 76 ̶ 0. 86) in the estimation cohort and 0. 71 (95%CI: 0. 62 ̶ 0. 79) in the validation cohort; RVR prediction: AUROC 0. 83 (95%CI: 0. 78 ̶ 0. 88) in the estimation cohort and 0. 82 (95%CI: 0. 76 ̶ 0. 88) in the validation cohort. Cost-analysis of standard 48-week treatment indicated a saving of 30. 3% if the prognostic tool is implemented. Conclusions: The combination of genetic (IL28B polymorphism) and viral genotype together with viral load, HIV co-infection and fibrosis stage defined a tool able to predict RVR and D1L at week 4. Using this tool would be a cost-saving strategy compared to universal triple therapy for hepatitis C.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Fibrosis ; Protease inhibitor therapy ; Viral load ; Hepatitis C ; Hepatitis C virus ; Variant genotypes ; Co-infections ; HIV
Publicat a:	PloS one, Vol. 10, No 3 (March 2015) , p. e0122613, ISSN 1932-6203

DOI: 10.1371/journal.pone.0122613
PMID: 25826755

13 p, 347.6 KB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
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