Pre-treatment prediction of response to peginterferon plusribavirin in chronic hepatitis C genotype 3

AIM： To evaluate pre-treatment factors associatedwith sustained virological response （SVR） in patientswith hepatitis C virus （HCV） genotype 3 treated withpeginterferon and ribavirin （RBV）.METHODS： We retrospectively analyzed treatmentnaive, mono-infected HCV genotype 3 patients treatedwith peginterferon and RBV. Exclusion criteria includedpresence of other liver disease, alcohol consumptionand African American or Asian ethnicity. The variablescollected and compared between patients who achievedan SVR and patients who did not were as follows：gender, age, fibrosis stage, diabetes, body mass index, steatosis, INFL3 polymorphism, pre treatment HCVRNA, type of peginterferon, RBV dose and adherence. RESULTS： A total of 107 patients treated between June, 2004 and March, 2013 were included. Mean treatment duration was 25.1 （± 1.8） wk. Overall, 58% （62/107） of the patients achieved an SVR and 42% （45/107） did not. In the multivariate logistic regression analysis, pre-treatment HCV-RNA ≥ 600000 UI/mL （OR = 0.375, 95%CI： 0.153-0.919, P = 0.032） and advanced fibrosis （OR = 0.278, 95%CI： 0.113-0.684, P = 0.005） were significantly associated with low SVR rates. In patients with pre-treatment HCV-RNA ≥ 600000 UI/mL and advanced fibrosis, the probability of achieving an SVR was 29% （95%CI： 13.1-45.2）. In patients with pre-treatment HCV-RNA 〈 600000 UI/mL and mild to moderate fibrosis, the probability of achieving an SVR was 81% （95%CI： 68.8-93.4）. CONCLUSION： In patients with HCV genotype 3 infections the presence of advance fibrosis and high pre-treatment viral load might be associated with poor response to peginterferon plus RBV. These patients could benefit the most from new direct antiviral agentsbased regimes.