Poster Presentations
Session Title: Category 5g. VIRAL HEPATITIS: g. HEPATITIS C - CLINICAL (THERAPY)
Presentation Date: Apr 15, 2010
SUSTAINED VIROLOGICAL RESPONSE (SVR) ACCORDING THE TYPE OF EARLY VIROLOGICAL RESPONSE (EVR) AND OTHER PROGNOSTIC FACTORS IN MONOINFECTED HCV AND COINFECTED HCV/HIV GENOTYPE 1 PATIENTS
P.R.L.d. Almeida1*, A.A.D. Mattos2, C.V. Tovo3
1Internal Medicine, Hospital Nossa Senhora da Conceição, 2Gastroenterology, Santa Casa de Porto Alegre, 3Hospital Nossa Senhora da Conceição, Post-Graduation Course of UFCSPA, Porto Alegre, Brazil. *paulorlalmeida@terra.com.br
Background: Some factors to predict the SVR are the genotype and the fibrosis grade, although there are others to be considered, mainly in coinfected patients HCV/HIV.
Objectives: Evaluate different prognostic factors to obtain SVR in HCV and HCV/HIV genotype 1.
Methods: Cohort study, retrospective, where the registers of patients monoinfected HCV or coinfected HCV/HIV, genotype 1 treated with peguilated interferon (PEG) + ribavirin (RBV) 48 weeks were reviewed. The prognostic factors viral load greater than 600,000UI/ml, age > 40 years and fibrosis grade were evaluated pre-treatment, and also the EVR considering the reduction of 2 logs or negative PCR in the week 12. Treatment was PEG alpha-2a 180 mcg or alpha-2b at a dose of 1.5 mcg/kg, once a week associated with RBV 1,000 mg/day for patients with less than 75 Kg or 1,250 mg/day for patients with 75 Kg or more, during 48 weeks. For statistical analysis, multivariated analysis was used. The significance level adopted was 5%.
Results: There were 323 monoinfected HCV and 59 coinfected HCV/HIV.
| viral load | fibrosis grade | age | <2 LOG RVS (%) | PCR (-) RVS (%) |
| F1+F2 | <40 >40 | 25.5 17.0 | 79.7 70.0 | |
| <600,000 UI/ml | F3 | <40 >40 | 17.3 11.1 | 70.5 58.8 |
| F4 | <40 >40 | 8.6 5.3 | 52.0 39.3 | |
| F1++F2 | <40 >40 | 19.4 12.6 | 73.4 62.2 | |
| >600,000 UI/ml | F3 | <40 >40 | 12.8 8.1 | 62.7 50.1 |
| F4 | <40 >40 | 6.2 3.8 | 43.2 31.3 |
| viral load | fibrosis grade | age | < 2logs RVS (%) | PCR (-) RVS (%) |
| F1+F2 | <40 >40 | 14.1 8.9 | 65.3 52.9 | |
| <6000,000 UI/ml | F3 | <40 >40 | 9.1 5.6 | 53.4 40.6 |
| F4 | <40 >40 | 4.3 2.6 | 34.1 23.6 | |
| F1+F2 | <40 >40 | 10.3 6.4 | 56.0 44.1 | |
| >6000,000UI/ml | F3 | <40 >40 | 6.6 4.0 | 44.6 32.5 |
| F4 | <40 >40 | 3.1 1.9 | 26.7 17.9 |
Conclusions: Patients with cirrhosis HCV genotype 1, high viral load, >40 years, coinfected with HIV or not, will present a very low SVR if did not obtain negative PCR in week 12 of treatment, and should be evaluated for discontinuation.
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