Predictors of a sustained virological response in patients with genotype 4 chronic hepatitis C

[Guest guest]

Liver International

OnlineEarly Articles

To cite this article: Rita Raafat Gad, Sylvia Males, Hesham El Makhzangy, Soheir

Shouman, Aboubakr Hasan, Mohamed Attala, Mostafa El Hoseiny, Khaled Zalata,

Mohamed Abdel-Hamid, Arnaud Fontanet, Mostafa K. Mohamed, Gamal Esmat (2008)

Predictors of a sustained virological response in patients with genotype 4

chronic hepatitis C

doi:10.1111/j.1478-3231.2008.01750.x

Abstract

CLINICAL STUDIES

Predictors of a sustained virological response in patients with genotype 4

chronic hepatitis C

Rita Raafat Gad11 Department of Community, Environmental and Occupational

Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt, Sylvia

Males22 Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur,

Paris, France, Hesham El Makhzangy33 Department of Tropical Medicine and

Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt, Soheir

Shouman44 Department of Tropical Diseases, National Hepatology and Tropical

Medicine and Research Institute, Cairo, Egypt, Aboubakr Hasan44 Department of

Tropical Diseases, National Hepatology and Tropical Medicine and Research

Institute, Cairo, Egypt, Mohamed Attala44 Department of Tropical Diseases,

National Hepatology and Tropical Medicine and Research Institute, Cairo, Egypt,

Mostafa El Hoseiny11 Department of Community, Environmental and Occupational

Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt, Khaled

Zalata55 Department of Pathology, Faculty of Medicine, University of Mansoura,

Mansoura, Egypt, Mohamed Abdel-Hamid6,76 Viral Hepatitis Reference Laboratory,

National Hepatology and Tropical Medicine and Research Institute, Cairo, Egypt7

Faculty of Medicine, Minia University, Minia, Egypt, Arnaud Fontanet22 Unité

d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France,

Mostafa K. Mohamed11 Department of Community, Environmental and Occupational

Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt and Gamal

Esmat33 Department of Tropical Medicine and Hepatology, Faculty of Medicine,

Cairo University, Cairo, Egypt1 Department of Community, Environmental and

Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

2 Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris,

France

3 Department of Tropical Medicine and Hepatology, Faculty of Medicine, Cairo

University, Cairo, Egypt

4 Department of Tropical Diseases, National Hepatology and Tropical Medicine and

Research Institute, Cairo, Egypt

5 Department of Pathology, Faculty of Medicine, University of Mansoura,

Mansoura, Egypt

6 Viral Hepatitis Reference Laboratory, National Hepatology and Tropical

Medicine and Research Institute, Cairo, Egypt

7 Faculty of Medicine, Minia University, Minia, Egypt

Correspondence

Dr Arnaud Fontanet, Unité d'Épidémiologie des Maladies Émergentes, Institut

Pasteur, 25 rue du Docteur Roux, Paris, France

Tel: +00 33 1 4061 3763

Fax: +00 33 1 4568 8876

e-mail: fontanet@...

Abstract

Objectives: To determine the clinical, biological, virological and histological

predictive factors associated with a sustained virological response (SVR) to

combined interferon therapy among Egyptian patients infected by genotype 4

hepatitis C virus (HCV).

Patients and Methods: Individual data from 250 patients with genotype 4 chronic

hepatitis C, treated with different regimens of combined interferon, were

analysed. The primary end point was SVR defined as undetectable HCV RNA by

polymerase chain reaction (PCR) 24 weeks after the end of treatment.

Multivariate logistic regression analysis was performed to select the

independent prognostic parameters associated with SVR.

Results: A sustained virological response was achieved among 137/250 (54.8%)

patients. Baseline factors independently and negatively associated with SVR were

serum α-fetoprotein (AFP) level (above 0.3 upper limit of normal) [odds ratio

(OR)=0.5, 95% confidence interval (CI): 0.2–0.8], severe fibrosis (Metavir

score>F2) (OR=0.4, 95% CI: 0.2–0.8), presence of steatosis (OR=0.5, 95% CI:

0.3–0.97) and standard interferon treatment (OR=0.4, 95% CI: 0.2–0.8).

Conclusions: Among genotype 4 chronic hepatitis C patients, severe fibrosis,

severe steatosis, treatment with standard interferon and a high serum AFP level

were all negatively associated with SVR. Pretreatment serum AFP level should be

considered in the routine assessment of factors predictive of a treatment

response.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1478-3231.2008.01750.x

_________________________________________________________________

More immediate than e-mail? Get instant access with Windows Live Messenger.

http://www.windowslive.com/messenger/overview.html?ocid=TXT_TAGLM_WL_Refresh_ins\

tantaccess_042008

[Guest guest]

Liver International

OnlineEarly Articles

To cite this article: Rita Raafat Gad, Sylvia Males, Hesham El Makhzangy, Soheir

Shouman, Aboubakr Hasan, Mohamed Attala, Mostafa El Hoseiny, Khaled Zalata,

Mohamed Abdel-Hamid, Arnaud Fontanet, Mostafa K. Mohamed, Gamal Esmat (2008)

Predictors of a sustained virological response in patients with genotype 4

chronic hepatitis C

doi:10.1111/j.1478-3231.2008.01750.x

Abstract

CLINICAL STUDIES

Predictors of a sustained virological response in patients with genotype 4

chronic hepatitis C

Rita Raafat Gad11 Department of Community, Environmental and Occupational

Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt, Sylvia

Males22 Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur,

Paris, France, Hesham El Makhzangy33 Department of Tropical Medicine and

Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt, Soheir

Shouman44 Department of Tropical Diseases, National Hepatology and Tropical

Medicine and Research Institute, Cairo, Egypt, Aboubakr Hasan44 Department of

Tropical Diseases, National Hepatology and Tropical Medicine and Research

Institute, Cairo, Egypt, Mohamed Attala44 Department of Tropical Diseases,

National Hepatology and Tropical Medicine and Research Institute, Cairo, Egypt,

Mostafa El Hoseiny11 Department of Community, Environmental and Occupational

Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt, Khaled

Zalata55 Department of Pathology, Faculty of Medicine, University of Mansoura,

Mansoura, Egypt, Mohamed Abdel-Hamid6,76 Viral Hepatitis Reference Laboratory,

National Hepatology and Tropical Medicine and Research Institute, Cairo, Egypt7

Faculty of Medicine, Minia University, Minia, Egypt, Arnaud Fontanet22 Unité

d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France,

Mostafa K. Mohamed11 Department of Community, Environmental and Occupational

Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt and Gamal

Esmat33 Department of Tropical Medicine and Hepatology, Faculty of Medicine,

Cairo University, Cairo, Egypt1 Department of Community, Environmental and

Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

2 Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris,

France

3 Department of Tropical Medicine and Hepatology, Faculty of Medicine, Cairo

University, Cairo, Egypt

4 Department of Tropical Diseases, National Hepatology and Tropical Medicine and

Research Institute, Cairo, Egypt

5 Department of Pathology, Faculty of Medicine, University of Mansoura,

Mansoura, Egypt

6 Viral Hepatitis Reference Laboratory, National Hepatology and Tropical

Medicine and Research Institute, Cairo, Egypt

7 Faculty of Medicine, Minia University, Minia, Egypt

Correspondence

Dr Arnaud Fontanet, Unité d'Épidémiologie des Maladies Émergentes, Institut

Pasteur, 25 rue du Docteur Roux, Paris, France

Tel: +00 33 1 4061 3763

Fax: +00 33 1 4568 8876

e-mail: fontanet@...

Abstract

Objectives: To determine the clinical, biological, virological and histological

predictive factors associated with a sustained virological response (SVR) to

combined interferon therapy among Egyptian patients infected by genotype 4

hepatitis C virus (HCV).

Patients and Methods: Individual data from 250 patients with genotype 4 chronic

hepatitis C, treated with different regimens of combined interferon, were

analysed. The primary end point was SVR defined as undetectable HCV RNA by

polymerase chain reaction (PCR) 24 weeks after the end of treatment.

Multivariate logistic regression analysis was performed to select the

independent prognostic parameters associated with SVR.

Results: A sustained virological response was achieved among 137/250 (54.8%)

patients. Baseline factors independently and negatively associated with SVR were

serum α-fetoprotein (AFP) level (above 0.3 upper limit of normal) [odds ratio

(OR)=0.5, 95% confidence interval (CI): 0.2–0.8], severe fibrosis (Metavir

score>F2) (OR=0.4, 95% CI: 0.2–0.8), presence of steatosis (OR=0.5, 95% CI:

0.3–0.97) and standard interferon treatment (OR=0.4, 95% CI: 0.2–0.8).

Conclusions: Among genotype 4 chronic hepatitis C patients, severe fibrosis,

severe steatosis, treatment with standard interferon and a high serum AFP level

were all negatively associated with SVR. Pretreatment serum AFP level should be

considered in the routine assessment of factors predictive of a treatment

response.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1478-3231.2008.01750.x

_________________________________________________________________

More immediate than e-mail? Get instant access with Windows Live Messenger.

http://www.windowslive.com/messenger/overview.html?ocid=TXT_TAGLM_WL_Refresh_ins\

tantaccess_042008

[Guest guest]

Liver International

OnlineEarly Articles

To cite this article: Rita Raafat Gad, Sylvia Males, Hesham El Makhzangy, Soheir

Shouman, Aboubakr Hasan, Mohamed Attala, Mostafa El Hoseiny, Khaled Zalata,

Mohamed Abdel-Hamid, Arnaud Fontanet, Mostafa K. Mohamed, Gamal Esmat (2008)

Predictors of a sustained virological response in patients with genotype 4

chronic hepatitis C

doi:10.1111/j.1478-3231.2008.01750.x

Abstract

CLINICAL STUDIES

Predictors of a sustained virological response in patients with genotype 4

chronic hepatitis C

Rita Raafat Gad11 Department of Community, Environmental and Occupational

Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt, Sylvia

Males22 Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur,

Paris, France, Hesham El Makhzangy33 Department of Tropical Medicine and

Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt, Soheir

Shouman44 Department of Tropical Diseases, National Hepatology and Tropical

Medicine and Research Institute, Cairo, Egypt, Aboubakr Hasan44 Department of

Tropical Diseases, National Hepatology and Tropical Medicine and Research

Institute, Cairo, Egypt, Mohamed Attala44 Department of Tropical Diseases,

National Hepatology and Tropical Medicine and Research Institute, Cairo, Egypt,

Mostafa El Hoseiny11 Department of Community, Environmental and Occupational

Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt, Khaled

Zalata55 Department of Pathology, Faculty of Medicine, University of Mansoura,

Mansoura, Egypt, Mohamed Abdel-Hamid6,76 Viral Hepatitis Reference Laboratory,

National Hepatology and Tropical Medicine and Research Institute, Cairo, Egypt7

Faculty of Medicine, Minia University, Minia, Egypt, Arnaud Fontanet22 Unité

d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France,

Mostafa K. Mohamed11 Department of Community, Environmental and Occupational

Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt and Gamal

Esmat33 Department of Tropical Medicine and Hepatology, Faculty of Medicine,

Cairo University, Cairo, Egypt1 Department of Community, Environmental and

Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

2 Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris,

France

3 Department of Tropical Medicine and Hepatology, Faculty of Medicine, Cairo

University, Cairo, Egypt

4 Department of Tropical Diseases, National Hepatology and Tropical Medicine and

Research Institute, Cairo, Egypt

5 Department of Pathology, Faculty of Medicine, University of Mansoura,

Mansoura, Egypt

6 Viral Hepatitis Reference Laboratory, National Hepatology and Tropical

Medicine and Research Institute, Cairo, Egypt

7 Faculty of Medicine, Minia University, Minia, Egypt

Correspondence

Dr Arnaud Fontanet, Unité d'Épidémiologie des Maladies Émergentes, Institut

Pasteur, 25 rue du Docteur Roux, Paris, France

Tel: +00 33 1 4061 3763

Fax: +00 33 1 4568 8876

e-mail: fontanet@...

Abstract

Objectives: To determine the clinical, biological, virological and histological

predictive factors associated with a sustained virological response (SVR) to

combined interferon therapy among Egyptian patients infected by genotype 4

hepatitis C virus (HCV).

Patients and Methods: Individual data from 250 patients with genotype 4 chronic

hepatitis C, treated with different regimens of combined interferon, were

analysed. The primary end point was SVR defined as undetectable HCV RNA by

polymerase chain reaction (PCR) 24 weeks after the end of treatment.

Multivariate logistic regression analysis was performed to select the

independent prognostic parameters associated with SVR.

Results: A sustained virological response was achieved among 137/250 (54.8%)

patients. Baseline factors independently and negatively associated with SVR were

serum α-fetoprotein (AFP) level (above 0.3 upper limit of normal) [odds ratio

(OR)=0.5, 95% confidence interval (CI): 0.2–0.8], severe fibrosis (Metavir

score>F2) (OR=0.4, 95% CI: 0.2–0.8), presence of steatosis (OR=0.5, 95% CI:

0.3–0.97) and standard interferon treatment (OR=0.4, 95% CI: 0.2–0.8).

Conclusions: Among genotype 4 chronic hepatitis C patients, severe fibrosis,

severe steatosis, treatment with standard interferon and a high serum AFP level

were all negatively associated with SVR. Pretreatment serum AFP level should be

considered in the routine assessment of factors predictive of a treatment

response.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1478-3231.2008.01750.x

_________________________________________________________________

More immediate than e-mail? Get instant access with Windows Live Messenger.

http://www.windowslive.com/messenger/overview.html?ocid=TXT_TAGLM_WL_Refresh_ins\

tantaccess_042008

[Guest guest]

Liver International

OnlineEarly Articles

To cite this article: Rita Raafat Gad, Sylvia Males, Hesham El Makhzangy, Soheir

Shouman, Aboubakr Hasan, Mohamed Attala, Mostafa El Hoseiny, Khaled Zalata,

Mohamed Abdel-Hamid, Arnaud Fontanet, Mostafa K. Mohamed, Gamal Esmat (2008)

Predictors of a sustained virological response in patients with genotype 4

chronic hepatitis C

doi:10.1111/j.1478-3231.2008.01750.x

Abstract

CLINICAL STUDIES

Predictors of a sustained virological response in patients with genotype 4

chronic hepatitis C

Rita Raafat Gad11 Department of Community, Environmental and Occupational

Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt, Sylvia

Males22 Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur,

Paris, France, Hesham El Makhzangy33 Department of Tropical Medicine and

Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt, Soheir

Shouman44 Department of Tropical Diseases, National Hepatology and Tropical

Medicine and Research Institute, Cairo, Egypt, Aboubakr Hasan44 Department of

Tropical Diseases, National Hepatology and Tropical Medicine and Research

Institute, Cairo, Egypt, Mohamed Attala44 Department of Tropical Diseases,

National Hepatology and Tropical Medicine and Research Institute, Cairo, Egypt,

Mostafa El Hoseiny11 Department of Community, Environmental and Occupational

Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt, Khaled

Zalata55 Department of Pathology, Faculty of Medicine, University of Mansoura,

Mansoura, Egypt, Mohamed Abdel-Hamid6,76 Viral Hepatitis Reference Laboratory,

National Hepatology and Tropical Medicine and Research Institute, Cairo, Egypt7

Faculty of Medicine, Minia University, Minia, Egypt, Arnaud Fontanet22 Unité

d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France,

Mostafa K. Mohamed11 Department of Community, Environmental and Occupational

Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt and Gamal

Esmat33 Department of Tropical Medicine and Hepatology, Faculty of Medicine,

Cairo University, Cairo, Egypt1 Department of Community, Environmental and

Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt

2 Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris,

France

3 Department of Tropical Medicine and Hepatology, Faculty of Medicine, Cairo

University, Cairo, Egypt

4 Department of Tropical Diseases, National Hepatology and Tropical Medicine and

Research Institute, Cairo, Egypt

5 Department of Pathology, Faculty of Medicine, University of Mansoura,

Mansoura, Egypt

6 Viral Hepatitis Reference Laboratory, National Hepatology and Tropical

Medicine and Research Institute, Cairo, Egypt

7 Faculty of Medicine, Minia University, Minia, Egypt

Correspondence

Dr Arnaud Fontanet, Unité d'Épidémiologie des Maladies Émergentes, Institut

Pasteur, 25 rue du Docteur Roux, Paris, France

Tel: +00 33 1 4061 3763

Fax: +00 33 1 4568 8876

e-mail: fontanet@...

Abstract

Objectives: To determine the clinical, biological, virological and histological

predictive factors associated with a sustained virological response (SVR) to

combined interferon therapy among Egyptian patients infected by genotype 4

hepatitis C virus (HCV).

Patients and Methods: Individual data from 250 patients with genotype 4 chronic

hepatitis C, treated with different regimens of combined interferon, were

analysed. The primary end point was SVR defined as undetectable HCV RNA by

polymerase chain reaction (PCR) 24 weeks after the end of treatment.

Multivariate logistic regression analysis was performed to select the

independent prognostic parameters associated with SVR.

Results: A sustained virological response was achieved among 137/250 (54.8%)

patients. Baseline factors independently and negatively associated with SVR were

serum α-fetoprotein (AFP) level (above 0.3 upper limit of normal) [odds ratio

(OR)=0.5, 95% confidence interval (CI): 0.2–0.8], severe fibrosis (Metavir

score>F2) (OR=0.4, 95% CI: 0.2–0.8), presence of steatosis (OR=0.5, 95% CI:

0.3–0.97) and standard interferon treatment (OR=0.4, 95% CI: 0.2–0.8).

Conclusions: Among genotype 4 chronic hepatitis C patients, severe fibrosis,

severe steatosis, treatment with standard interferon and a high serum AFP level

were all negatively associated with SVR. Pretreatment serum AFP level should be

considered in the routine assessment of factors predictive of a treatment

response.

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1478-3231.2008.01750.x

_________________________________________________________________

More immediate than e-mail? Get instant access with Windows Live Messenger.

http://www.windowslive.com/messenger/overview.html?ocid=TXT_TAGLM_WL_Refresh_ins\

tantaccess_042008