Published in:
Open Access
01-12-2012 | Research article
HCV genotype 1a shows a better virological response to antiviral therapy than HCV genotype 1b
Authors:
Adriano M Pellicelli, Mario Romano, Tommaso Stroffolini, Ettore Mazzoni, Fabrizio Mecenate, Roberto Monarca, Antonio Picardi, Maria Elena Bonaventura, Cristina Mastropietro, Pascal Vignally, Arnaldo Andreoli, Massimo Marignani, Cecilia D’Ambrosio, Lucia Miglioresi, Lorenzo Nosotti, Olga Mitidieri, Umberto Vespasiani Gentilucci, Claudio Puoti, Giuseppe Barbaro, Angelo Barlattani, Caterina Furlan, Giorgio Barbarini, and for the CLEO Group
Published in:
BMC Gastroenterology
|
Issue 1/2012
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Abstract
Background
The impact of viral subtype on the rate of sustained virological response (SVR) to antiviral therapy in patients chronically infected with hepatitis C genotype 1 subtype 1a and 1b has not been extensively investigated. The aim of this study is to determine whether the HCV genotype 1 subtypes 1a and 1b respond differently to treatment with PEGylated interferon (PEG-IFN) plus ribavirin.
Methods
For 48 weeks, 388 “naïve”genotype 1 patients were treated weekly with PEG-IFN α-2a or PEG-INF α-2b combined with daily ribavirin (1000–1200 mg/day). The numbers of patients in whom HCV-RNA was undetectable were compared after 4 (rapid virological response, RVR), 12 (early virological response, EVR), and 48 (end treatment virological response, ETR) weeks of treatment as well as 24 weeks after the last treatment (sustained virological response, SVR).
Results
The rate of SVR was higher in subtype 1a patients than subtype 1b patients (55% vs. 43%; p < 0.02). Multiple logistic regression analysis showed that infection with genotype 1a (odds ratio(OR) : 1.8; 95% confidence interval (CI): 1.4 to 4.1), age < 50 years (OR:7.0; 95% CI 1.1 to 21.2), alanine aminotransferase level (ALT)<100 IU/ml (OR:2.1; 95% CI: 1.3 to3.5), HCV-RNA < 5.6 log10 IU/ml (OR: 3.2; 95% CI: 2.7 to 6.9) and fibrosis score < S3 (OR: 3.8; 95% CI:3.2 to 7.4), were all independent predictors of SVR.
Conclusion
Dual antiviral therapy is more effective against HCV subtype 1a than against subtype 1b and this difference is independent of other factors that may favour viral clearance.
Trial registration
ClinicalTrials.gov Identifier: NCT01342003