Prediction of week 4 virological response in hepatitis C for making decision on triple therapy: the Optim study.

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• dc.contributor.author Romero Gómez, Manuelca
• dc.contributor.author Turnes, Juanca
• dc.contributor.author Ampuero, Javierca
• dc.contributor.author Oyagüez, Itziarca
• dc.contributor.author Cuenca, Beatrizca
• dc.contributor.author Gonzalez-Garcia, Juanca
• dc.contributor.author Muñoz-Molina, Belénca
• dc.contributor.author Aguilar, Rocioca
• dc.contributor.author Leal, Sandraca
• dc.contributor.author Planas, Ramonca
• dc.contributor.author Garcia-Samaniego, Javierca
• dc.contributor.author Diago, Moisesca
• dc.contributor.author Crespo, Javierca
• dc.contributor.author Calleja, Jose Luisca
• dc.contributor.author Casado, Miguel Angelca
• dc.contributor.author Solà Lamoglia, Ricardca
• dc.date.accessioned 2015-05-25T08:17:16Z
• dc.date.available 2015-05-25T08:17:16Z
• dc.date.issued 2015
• dc.description.abstract BACKGROUND: Virological response to peginterferon + ribavirin (P+R) at week 4 can predict sustained virological response (SVR). While patients with rapid virological response (RVR) do not require triple therapy, patients with a decline <1 log10 IU/ml HCVRNA (D1L) should have treatment discontinued due to low SVR rate. AIM: To develop a tool to predict first 4 weeks' viral response in patients with hepatitis C genotype 1&4 treated with P+R. METHODS: In this prospective and multicenter study, HCV mono-infected (n=538) and HCV/HIV co-infected (n=186) patients were included. To develop and validate a prognostic tool to detect RVR and D1L, we segregated the patients as an estimation cohort (to construct the model) and a validation cohort (to validate the model). RESULTS: D1L was reached in 509 (80.2%) and RVR in 148 (22.5%) patients. Multivariate analyses demonstrated that HIV co-infection, Forns' index, LVL, IL28B-CC and Genotype-1 were independently related to RVR as well as D1L. Diagnostic accuracy (AUROC) for D1L was: 0.81 (95%CI: 0.76 ̶ 0.86) in the estimation cohort and 0.71 (95%CI: 0.62 ̶ 0.79) in the validation cohort; RVR prediction: AUROC 0.83 (95%CI: 0.78 ̶ 0.88) in the estimation cohort and 0.82 (95%CI: 0.76 ̶ 0.88) in the validation cohort. Cost-analysis of standard 48-week treatment indicated a saving of 30.3% if the prognostic tool is implemented. CONCLUSIONS:/nThe combination of genetic (IL28B polymorphism) and viral genotype together with viral load, HIV co-infection and fibrosis stage defined a tool able to predict RVR and D1L at week 4. Using this tool would be a cost-saving strategy compared to universal triple therapy for hepatitis C.ca
• dc.format.mimetype application/pdfca
• dc.identifier.citation Romero-Gómez M, Turnes J, Ampuero J, Oyagüez I, Cuenca B, Gonzalez-Garcia J. et. al. Prediction of Week 4 Virological Response in Hepatitis C for Making Decision on Triple Therapy: The Optim Study. /n PLoS One. 2015 Mar 31;10(3):e0122613. doi: 10.1371/journal.pone.0122613. eCollection 2015.ca
• dc.identifier.doi http://dx.doi.org/10.1371/journal.pone.0122613
• dc.identifier.issn 1932-6203
• dc.identifier.uri http://hdl.handle.net/10230/23636
• dc.language.iso engca
• dc.publisher Public Library of Scienceca
• dc.relation.ispartof PLoS One. 2015 Mar 31;10(3):e0122613
• dc.rights © 2015 Romero-Gómez et al. This is anopen access article distributed under the terms of the http://creativecommons.org/licenses/by/4.0/, which permitsunrestricted use, distribution, and reproduction in anymedium, provided the original author and source arecredited.ca
• dc.rights.accessRights info:eu-repo/semantics/openAccessca
• dc.rights.uri http://creativecommons.org/licenses/by/4.0/ca
• dc.subject.other Hepatitis Cca
• dc.subject.other Virologiaca
• dc.title Prediction of week 4 virological response in hepatitis C for making decision on triple therapy: the Optim study.ca
• dc.type info:eu-repo/semantics/articleca
• dc.type.version info:eu-repo/semantics/publishedVersionca