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Open Access Highly Accessed Research article

Effectiveness of treatment with pegylated interferon and ribavirin in an unselected population of patients with chronic hepatitis C: A Danish nationwide cohort study

Nanna Hansen1, Niels Obel2, Peer B Christensen3, Mette Kjær4, Alex L Laursen5, Henrik B Krarup6, Axel Møller7, Poul Schlichting8, Jens Bukh9, Nina Weis110* and the Danish Database for Hepatitis B and C (DANHEP)- group

Author Affiliations

1 Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, 2650 Hvidovre, Denmark

2 Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen Ø, Denmark

3 Department of Infectious Diseases, Odense University Hospital, 5000 Odense, Denmark

4 Department of Hepatology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen Ø, Denmark

5 Department of Infectious Diseases, Aarhus University Hospital, Skejby, 8000 Aarhus, Denmark

6 Department of Gastroenterology and Biochemistry, Unit for Molecular Diagnostics, Aalborg University Hospital, 9100 Aalborg, Denmark

7 Department of Internal Medicine, Kolding Hospital, 6000 Kolding, Denmark

8 Department of Gastroenterology, Herlev University Hospital, 2730 Herlev, Denmark

9 Copenhagen Hepatitis C Program (CO-HEP), Department of Infectious Diseases and Clinical Research Centre, Copenhagen University Hospital, Hvidovre, 2650 Hvidovre, Denmark and Department of International Health, Immunology and Microbiology, Faculty of Health Sciences, University of Copenhagen, 2100 Copenhagen Ø, Denmark

10 Faculty of Health Sciences, University of Copenhagen, Denmark, 2100 Copenhagen Ø, Denmark

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BMC Infectious Diseases 2011, 11:177  doi:10.1186/1471-2334-11-177

Published: 21 June 2011

Abstract

Background

The effect of peginterferon and ribavirin treatment on chronic hepatitis C virus (HCV) infection has been established in several controlled clinical studies. However, the effectiveness of treatment and predictors of treatment success in routine clinical practice remains to be established. Our aim was to estimate the effectiveness of peginterferon and ribavirin treatment in unselected HCV patients handled in routine clinical practice. The endpoint was sustained virological response (SVR), determined by the absence of HCV RNA 24 weeks after the end of treatment.

Methods

We determined the proportion of SVR in a nationwide, population-based cohort of 432 patients with chronic HCV infection who were starting treatment, and analyzed the impact of known covariates on SVR by using a logistic regression analysis.

Results

The majority of treated patients had genotype 1 (133 patients) and genotype 2/3 (285 patients) infections, with 44% and 72%, respectively, obtaining SVR. Other than genotype, the predictors of SVR were age ≤ 45 years at the start of treatment, completion of unmodified treatment, the absence of cirrhosis and non-European origin.

Conclusions

The effectiveness of peginterferon and ribavirin treatment for chronic hepatitis C in a routine clinical practice is comparable to that observed in controlled clinical trials, with a higher SVR rate in genotype 2 and 3 patients compared to genotype 1 patients. Our data further indicate that age at start of treatment is a strong predictor of SVR irrespective of HCV genotype, with patients 45 years or younger having a higher SVR rate.