par Bourgeois, Stefan;Moreno, Christophe ;Deltenre, Pierre ;Delwaide, Jean;Henrion, Jean;Adler, Michael ;Langlet, Philippe ;Mulkay, Jean-Pierre ;Nevens, Frederik;Brixko, Christian
Référence Acta gastro-enterologica Belgica (Ed. multilingue), 77, 4, page (393-400)
Publication Publié, 2014-12
Référence Acta gastro-enterologica Belgica (Ed. multilingue), 77, 4, page (393-400)
Publication Publié, 2014-12
Article révisé par les pairs
Résumé : | Background and study aims: This was an observational, non-interventional, multicenter, phase IV study, in patients with genotype 1/4/5/6 chronic hepatitis C (CHC). The primary objectives were to evaluate SVR in patients with no or minimal fibrosis (METAVIR F0-F1) versus well established fibrosis (F2-F4), and to estimate response on Weeks 12, 24 and 48 on treatment in previously untreated patients with genotypes 1/4/5/6 CHC. Patients and methods: 538 patients treated with pegylated interferon alfa 2b 1.5 mcg/kg in combination with ribavirin 800- 1200 mg/day were enrolled in 55 sites in Belgium and Luxembourg, 505 being considered for the analysis. 40% of the patients were female and 60% male, the average age was 47.5 years, 10.5% were 65 or older. Results: SVR was observed in 35% of the patients, EVR in 68%, of which pEVR in 33% and cEVR in 35%. SVR was observed in 43% of the low fibrosis group (F0, F1) and 30% of the high fibrosis group (F2, F3, F4) (p = 0.005). SVR rates were 34% for genotype 1, 37% for genotype 4, and 47% for genotype 5 (NS). Multivariate analysis showed that EVR and baseline METAVIR score are independent prognostic factors for SVR. Conclusions: This trial confirms that fibrosis stage and early viral response are the most important key-factors to predict sustained response, suggesting that the earlier patients are treated, the better the outcome. Non-invasive techniques enable us to closely monitor progression of fibrosis, allowing a better selection of patients for antiviral treatment in the DAA-era. |