Sustained virologic response (SVR) following antiviral therapy in genotype 2 and 3 HCV patients is accomplished in most cases, although a small number of patients fail to respond (NR) or relapse (Rel) after discontinuation of therapy.

Understanding predictors of treatment failure in this “highly treatment-sensitive” population may allow the development of novel therapeutic approaches. The aim of the present study, presented at DDW 2005, was to assess predictors of treatment failure (NR and Rel) in patients with HCV genotypes 2 and 3.

All treatment-naive Caucasian patients with chronic HCV genotype 2 and 3 infection at The Cleveland Clinic Foundation between 2001 and 2004 were identified (59 patients).

Those who received at least one dose of peginterferon (fixed dose PEG 2a [Pegasys] or weight-based PEG 2b) [PegIntron] and ribavirin were included whereas liver transplant recipients, co-infected hepatitis B and/or HIV patients were excluded.

Identification of variables associated with treatment failure was done by comparing variables of interest between SVR and non-SVR groups using Wilcoxon test for continuous variables and Chi-Square for categorical variables.

Individual logistic regression was done to obtain Odds Ratios (OR).

Multivariate modeling was done to identify independent predictors of treatment failure.

Results
· Overall, 14/59 (24%) patients failed to achieve SVR (7 NR and 7 Rel).

· Male gender, history of alcohol abuse, non-weight-based therapy, and presence of histologically advanced disease were identified as predictors of failure to achieve SVR by univariate analysis.

· Multivariable logistic regression analysis model (whole model p=0.0006) identified history of alcohol abuse and non-weight-based treatment as significant independent predictors of failure to achieve SVR in these patients.

· More patients with genotype 3 failed to achieve SVR, although not statistically significant.

Conclusions

The authors conclude, “A subgroup of Caucasian HCV patients with genotype 2 and 3 infections less likely to achieve SVR may potentially benefit from weight-based peginterferon therapy.”

“Excessive alcohol intake appears to contribute to treatment failure in patients infected with HCV genotype 2 or 3 infections”

“Novel therapeutic approaches such as longer duration of treatment may lead to better outcomes in this population.”

A M Qadri and others. Predictors Of Treatment Failure in Patients With Hepatitis C Genotypes 2 or 3 Infections. Abstract S1565. DDW 2005. May 14-18, 2005. Chicago, IL.

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Thank you to Ron Baker, www.hivandhepatitis.com for the above two articles.