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Changes in the response to treatment against chronic hepatitis C between 1999 and 2015: data from a prospective cohort

Mancebo, María; Real, Luis M.; Mira, José A.; Recio, Eva; Pérez, Elisabet; Monje-Agudo, Patricia; Merchante, Nicolás; Macías, Juan; Neukam, Karin; Pineda, Juan A.

European Journal of Gastroenterology & Hepatology: November 2016 - Volume 28 - Issue 11 - p 1253–1257
doi: 10.1097/MEG.0000000000000705
Original Articles: Hepatitis

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 r2=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 r2=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.

aUnit of Infectious Diseases and Microbiology

bInternal Medicine Department, Hospital Universitario de Valme

cBiomedical Institute of Seville (IBIS), Seville, Spain

Correspondence to Karin Neukam, PhD, Unit of Infectious Diseases and Microbiology, Hospital Universitario de Valme, Avda, Bellavista s/n 41014, Seville, Spain Tel: +34 955 015 799; fax: +34 955 015 795; e-mail: karin.neukam@gmail.com

Received April 26, 2016

Accepted June 13, 2016

Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.