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Scripta Scientifica Medica

Baseline viral load - a predictor of treatment response in advanced hepatitis C

Irina Ivanova, Iskren Kotsev, Maria Atanassova, Antonia Atanassova, Bogomila Manevska, Ivan Krasnaliev, Trifon Chervenkov, Svetoslav Balev

Abstract

PURPOSE: The stage of liver disease and genotype of hepatitis C virus (HCV) are well-defined predictors for therapeutic success in chronic hepatitis C. This study aimed at assessing the prognostic role of baseline viral load for response to antiviral therapy in genotype 1 infected patients.

MATERIAL AND METHODS: The study covered a total of 163 patients with hepatitis C, 93 of them with absent, mild or septal fibrosis (F0-F2) and 70 cases with bridging fibrosis (F3) or cirrhosis (F4). Viral load (HCV RNA) was determined with a sensitive RT-PCR technique. A high baseline viraemia was defined if HCV RNA exceeded 600000 IU/mL. All the patients were treated with peginterferon alfa and ribavirin for 24 to 48 weeks. They achieved a sustained viral response (SVR) if HCV RNA was undetectable six month after therapy cessation.

RESULTS: SVR was registered in 80.6% of the patients with F0-F2 fibrosis stage, in 51.4% of those with F3-F4 fibrosis and in only 25% of 12 patients with early Child B cirrhosis or with present esophageal varices. Baseline viral load was not a prognostic factor for therapeutic effectiveness in early hepatitis C stage. However, in the advanced fibrosis stage, patients who achieved viral eradication had a significantly lower level of HCV RNA (440000 IU/mL) then those with relapse or non-response to therapy (997000 IU/mL).

CONCLUSION: The most difficult-to-treat patients with HCV genotype 1 and advanced liver disease may successfully receive a standard treatment. The SVR rate is 51.4%, reaching the results of current triple therapy for F3-F4 stage. The viral eradication is associated with a low baseline viral load.

Scripta Scientifica Medica 2013; 45(3): 53-57.


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DOI: http://dx.doi.org/10.14748/ssm.v45i3.306

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About The Authors

Irina Ivanova
Medical University of Varna
Bulgaria

Clinic of Gastroenterology

Iskren Kotsev
Medical University of Varna
Bulgaria

Clinic of Gastroenterology

Maria Atanassova
Medical University of Varna
Bulgaria

Clinic of Gastroenterology

Antonia Atanassova
Medical University of Varna
Bulgaria

Clinic of Gastroenterology

Bogomila Manevska
Medical University of Varna
Bulgaria

Department of Pathology

Ivan Krasnaliev
Medical University of Varna
Bulgaria

Department of Pathology

Trifon Chervenkov
Medical University of Varna
Bulgaria

Laboratory of Clinical Immunology, St. Marina University Hospital of Varna

Svetoslav Balev
Medical University of Varna
Bulgaria

Laboratory of Clinical Immunology, St. Marina University Hospital of Varna

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