A Predictive Model For Selecting Patients With Hcv Genotype 3 Chronic Infection With A High Probability Of Sustained Virological Response To Peginterferon Alfa-2 Alpha/Ribavirin

BackgroundAccess to direct-acting antiviral agents (DAAs) is restricted in some settings; thus, the European Association for the Study of the Liver recommends dual peginterferon/ribavirin (PegIFN/RBV) therapy wherever DAAs are unavailable. HCV genotype (GT) 3 infection is now the most difficult genotype to eradicate and PegIFN/RBV remains an effective option. The goal of this study was to devise a simple predictive score to identify GT3 patients with a high probability of achieving a sustained virologic response (SVR) with PegIFN alfa-2a/RBV therapy.MethodsRelationships between baseline characteristics and SVR were explored by multiple logistic regression models and used to develop a simple scoring system to predict SVR using data from 1239 treatment-naive GT3 patients who received PegIFN alfa-2a/RBV for 24 weeks in two large observational cohort studies.ResultsThe score was validated using a database of 473 patients. Scores were assigned for six factors as follows: age (years) (<= 40: 2 points; >40 but <= 55: 1); bodyweight (kg) (<70: 2; >= 70 but <90: 1); no cirrhosis/transition to cirrhosis (2); ALT <= 2.5 x ULN (1); platelets (10(9)/L) (>200: 2; >= 100 but <200: 1); HCV RNA (<400,000 IU/mL: 1). The points are summed to arrive at a score ranging from 0-10 where higher scores indicate higher chances of SVR; 141, 123, 203, 249, 232, and 218 patients had total scores of 0-4, 5, 6, 7, 8, and 9-10, respectively, among whom SVR rates were 45%, 62%, 72%, 76%, 84%, and 89%. Among 622 patients who had scores of 6-10 and HCV RNA <50 IU/mL by treatment week 4 the SVR rate was 86% (532/622).ConclusionsA simple baseline scoring system involving age, bodyweight, cirrhosis status, ALT level, platelet count and HCV RNA level can be used to identify treatment-naive Caucasian patients with HCV GT3 infection with a high probability of SVR with PegIFN alfa-2a/RBV therapy.