Analysis of predictive factors for rapid virologic response in treating patients with chronic hepatitis C

Objective To analyze the predictive factors for rapid virologic response (RVR) in patients with chronic hepatitis C (CHC) who received combination therapy with pegylated interferon (PEG-IFN) and ribavirin. Methods A total of 127 CHC patients who were admitted to our department from 2010 to 2012 and received PEG-IFN combined with ribavirin were enrolled in this retrospective cohort study. The patients were divided into RVR group and non-RVR (NRVR) group according to their virologic responses after 4 weeks of antiviral therapy.Demographic characteristics and the clinical features prior to treatment were compared between the two groups, and the potential factors that contributed to the acquisition of RVR were analyzed. Comparison of categorical data between groups was made by chi-square test, predictive factors were analyzed by nonparametric test for two independent samples (Mann-Whitney U test) , independent predictive factors were tested by univariate and multivariate logistic regression analyses, and the continuous variables of predictive factors were analyzed using receiver operating characteristic curves. Results Of the 127 CHC patients, 86 were males and 41 females. There were 11 confirmed cases of liver cirrhosis. There were 100 patients (78. 74%) who achieved an RVR, and 27 (21. 26%) with NRVR. Nonparametric analysis showed that eight factors, which were age, time of infection, level of pre-treatment alanine aminotransferase, level of pre-treatment hyaluronic acid, development of hypertension, type of interferon, pathway of infection, and hepatitis C virus (HCV) genotype, were significantly different between the RVR and NRVR groups (P < 0. 05) . The logistic regression analysis identified the following factors as independent predictive factors for RVR: non-genotype 1 (OR: 0. 203, 95% CI: 0. 051-0. 802, P < 0. 05) , time of infection (OR: 0. 925, 95% CI: 0. 868-0. 987, P < 0. 05) , and absence of hypertension (OR: 0. 129, 95% CI: 0. 032-0. 521, P < 0. 05) . Conclusion Patients with shorter history of HCV infection, absence of complicated hypertension, and non-genotype 1 HCV infection have an increased likelihood of achieving an RVR.