Is pre-treatment liver biopsy necessary for all hepatitis C genotypes?

نویسندگان

  • Kevork M Peltekian
  • Vincent G Bain
  • Samuel S Lee
  • Morris Sherman
  • Curtis L Cooper
  • Eric M Yoshida
  • Paul J Marotta
  • Mel Krajden
  • Robert Balshaw
  • Marc Deschênes
چکیده

BACKGROUND Current practice guidelines recommend liver biopsy prior to treatment of hepatitis C genotype-1 but not for genotype-2/3; this is based on expert opinion, not on published evidence. METHODS In retrospective analysis of a large trial database prior to the publication of recent guidelines, we compared outcomes in 985 treatment-naïve patients with hepatitis C who did or did not undergo liver biopsy before starting peginterferon alfa-2a plus ribavirin. RESULTS Physicians elected to treat 141/654 (21.6%) genotype-1 patients and 126/331 (38.1%) genotype-2/3 patients without liver biopsy. There were no differences in baseline characteristics among those with or without pre-treatment liver biopsy, except for female preponderance in genotype-1 patients with liver biopsy. The sustained viral response (SVR) rate was no different amongst genotype-2/3 patients who had a biopsy before treatment with 66.3% SVR vs. 69.8% of those treated without biopsy (p = 0.546), but significantly higher among genotype-1 patients with pre-treatment liver biopsy at 54.6 vs. 44.0% for those treated without a liver biopsy (p = 0.029). In genotype-1 patients with liver biopsy, more patients with cirrhosis had dose adjustments (p = 0.0057) rather than drug discontinuation. There was tendency for earlier discontinuation among patients without pre-treatment liver biopsy. CONCLUSIONS Pre-treatment liver biopsy was associated with better SVR amongst genotype-1 patients. This improvement may reflect ongoing commitment to completing the treatment course by both patient and physician. In genotype-2/3 patients, pre-treatment liver biopsy may not be essential to maximize SVR rates. This study validates the recommendations of the most recent treatment guidelines for hepatitis C.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Detection of Pre-treatment mutations leading to resistance to direct hepatitis C virus blocking drugs in patients with chronic hepatitis C

Background and objective: Human is the only host of hepatitis C virus. This virus has a positive single stranded RNA and lipoprotein envelop that has 7 confirmed genotypes. According to studies, genotypes 1a, 3a and 1b are the most common genotypes in Iran. No effective vaccine against HCV infection has been developed instead, advances in antiviral treatment using drugs that directly affect spe...

متن کامل

بررسی حضور ژنوتیپ‌های مختلف ویروس هپاتیت C در سرم، سلول‌های تک‌هسته‌ای خون محیطی و نمونه بیوپسی کبد بیماران مبتلا به عفونت مزمن هپاتیت C

Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal" mso-tstyle-rowband-size:0 mso-tstyle-colband-size:0 mso-style-noshow:yes mso-style-priority:99 mso-style-qformat:yes ms...

متن کامل

بررسی اثر درمانی آلفا اینترفرون نوع 2a (رفرون) روی بیمـاران مبتـلا به هپاتیـت مزمن C

Hepatitis C virus infection is affecting an estimated 200 million people worldwide and 210 thousand in Iran. It is a major cause of morbidity and mortality from liver disease. Interferon-alpha is the choice of treatment but interferone (IFN) with ribavirin is known more effective recently. This study evaluated effect of IFN on Iranian patients and predict response to therapy. This i...

متن کامل

Detection of SENV Virus in Healthy, Hepatitis B- and Hepatitis C-Infected Individuals in Yazd Province, Iran

Background: SEN virus (SENV) is the latest virus proposed as a cause of unknown hepatitis cases. Among nine detected genotypes of the virus, genotypes D and H are more frequent in hepatitis cases of unknown origin. The aim of this study was to determine the frequency of SENV-D and SENV-H genotypes in the sera of healthy individuals and hepatitis B and C patients. Methods: Totally, 200 serum sam...

متن کامل

Autoimmune hepatitis

Autoimmune hepatitis is (AIH) is a chronic hepatitis that occurs in children and adults of all ages. It is characterized by immunologic and autoimmune features, including circulating auto antibodies and high serum globulin concentrations. It was first described in the 1950s by term of chronic active hepatitis. It has 2 types with different auto antibodies. Diagnosis is based upon serologic and ...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Annals of hepatology

دوره 10 3  شماره 

صفحات  -

تاریخ انتشار 2011