Steatosis is an independent predictor of relapse following rapid virologic response in patients with HCV genotype 3.

Published

Journal Article

BACKGROUND & AIMS: It is recommended that patients with chronic hepatitis C virus (HCV) genotype 3 infections receive 24 weeks of treatment. A rapid virologic response (RVR; at week 4) predicts a sustained virologic response (SVR), although not all patients with an RVR achieve an SVR. We explored the relationships among hepatic steatosis, level of HCV RNA, relapse, and RVR in a phase 3 randomized controlled trial of 932 patients infected with HCV genotype 2 (n = 427) or 3 (n = 505) who received 24 weeks of therapy with interferon-α. METHODS: In patients with an RVR (HCV RNA <43 IU/mL), the presence of an SVR was modeled using multivariate logistic regression as a function of age, sex, weight, body mass index, insulin resistance, steatosis, and levels of γ-glutamyl transpeptidase, alanine aminotransferase, liver fibrosis, and baseline HCV RNA. RESULTS: RVR, SVR, and relapse rates among patients with HCV genotype 3 were 79.6%, 79.2%, and 15.6%, respectively; corresponding rates among patients with HCV genotype 2 were 86.7%, 84.3%, and 10.1%. An RVR had high predictive value for an SVR in patients with HCV genotypes 2 (88.9%) and 3 (88.1%). The strongest independent predictors of relapse in patients with genotype 3 and an RVR were steatosis (odds ratio 3.0; P = .003) and HCV RNA ≥400,000 IU/mL (odds ratio 2.5; P = .04). Relapse rates in patients with steatosis were 17.4% and 20.9% for low and high baseline levels of HCV RNA, respectively; corresponding rates in those without steatosis were 2.5% and 8.8%. CONCLUSIONS: Steatosis was associated with significantly higher rates of relapse, irrespective of viral load, in patients infected with HCV genotype 3 who had an RVR. Further studies are needed to determine if longer treatment durations are effective in patients with an RVR and these risk factors.

Full Text

Duke Authors

Cited Authors

  • Shah, SR; Patel, K; Marcellin, P; Foster, GR; Manns, M; Kottilil, S; Healey, L; Pulkstenis, E; Subramanian, GM; McHutchison, JG; Sulkowski, MS; Zeuzem, S; Nelson, DR

Published Date

  • August 2011

Published In

Volume / Issue

  • 9 / 8

Start / End Page

  • 688 - 693

PubMed ID

  • 21640198

Pubmed Central ID

  • 21640198

Electronic International Standard Serial Number (EISSN)

  • 1542-7714

Digital Object Identifier (DOI)

  • 10.1016/j.cgh.2011.04.029

Language

  • eng

Conference Location

  • United States