The Role of Weight Loss as On-Treatment Predictive Factor for SVR in the Treatment of Chronic Hepatitis C Patients with Peginterferon alfa-2a and Ribavirin

Abstract

AIM: Pegylated interferon-alpha (PEG) and ribavirin (RBV) is the mostly used treatment for patients with chronic hepatitis C (CHC) leading to a strong and in many patients sustained viral response (SVR). In this study we analyzed the value of weight loss under PEG/RBV treatment as an easy to recognize on-treatment predictive factor besides viral response. Methods: We conducted a Phase IV, multi-center, open-label, non-interventional study with treatment of Peginterferon alfa-2a and ribavirin. 1100 patients treated with a complete course of CHC therapy according to consensus recommendations (GT-1/4/5/6 for 48±4wks, GT-2/3 for 24±2wks). For these patients descriptive, univariate and multivariate analyses were performed to determine on-treatment predictive factors associated with SVR. Results: In 737 genotype 1/4/5/6 infected patients the SVR rate was 39.3%. However, patients with a weight loss ≥2 kg under therapy achieved an (P=0.000, OR=2.361, 95%-CI: 1.639 – 3.403) statistically significant increased SVR of up to 44.4% whereas patients with a lower weight loss <2 kg showed only a SVR of 25.3%. In 363 patients with genotype 2/3 the overall SVR rate was 64.5% and in case of weight loss of more than 2 kg they achieved a SVR of 68.8% whereas patients who lost less than 2 kg showed a SVR of only 55.2%. A multivariate regression analysis revealed that EVR, RVR, age and weight loss under therapy but not genotypes have been positive and significant on-treatment predictors for SVR. Conclusion: The present study demonstrates that weight loss is a reliable on-treatment predictive factor for estimating treatment outcome.