Please use this identifier to cite or link to this item: http://repositorio.unicamp.br/jspui/handle/REPOSIP/601
Type: Artigo de periódico
Title: FibroTest is an independent predictor of virologic response in chronic hepatitis C patients retreated with pegylated interferon alfa-2b and ribavirin in the EPIC(3) program
Author: POYNARD, Thierry
MUNTEANU, Mona
COLOMBO, Massimo
BRUIX, Jordi
SCHIFF, Eugene
TERG, Ruben
FLAMM, Steven
MORENO-OTERO, Ricardo
CARRILHO, Flair
SCHMIDT, Warren
BERG, Thomas
MCGARRITY, Thomas
HEATHCOTE, E. Jenny
GONCALES, Fernando
DIAGO, Moises
CRAXI, Antonio
SILVA, Marcelo
BOPARAI, Navdeep
GRIFFEL, Louis
BURROUGHS, Margaret
BRASS, Clifford
ALBRECHT, Janice
Abstract: Background & Aims: EPIC-3 is a prospective, international study that has demonstrated the efficacy of PEG-IFN alfa-2b plus weight-based ribavirin in patients with chronic hepatitis C and significant fibrosis who previously failed any interferon-alfa/ribavirin therapy. The aim of the present study was to assess FibroTest (FT), a validated non-invasive marker of fibrosis in treatment-naive patients, as a possible alternative to biopsy as the baseline predictor of subsequent early virologic (EVR) and sustained virologic response (SVR) in previously treated patients. Methods: Of 2312 patients enrolled, 1459 had an available baseline FT, biopsy, and complete data. Uni- (UV) and multi-variable (MV) analyses were performed using FT and biopsy. Results: Baseline characteristics were similar as in the overall population; METAVIR stage: 28% F2, 29% F3, and 43% F4, previous relapsers 29%, previous PEG-IFN regimen 41%, high baseline viral load (BVL) 64%. 506 patients (35%) had undetectable HCV-RNA at TW12 (TW12neg), with 58% achieving SVR. The accuracy of FT was similar to that in naive patients: AUROC curve for the diagnosis of F4 vs F2 = 0.80 (p<0.00001). Five baseline factors were associated (p<0.001) with SVR in UV and MV analyses (odds ratio: UV/MV): fibrosis stage estimated using FT (4.5/5.9) or biopsy (1.5/1.6), genotype 2/3 (4.5/5.1), BVL (1.5/1.3), prior relapse (1.6/1.6), previous treatment with non-PEG-IFN (2.6/2.0). These same factors were associated (p <= 0.001) with EVR. Among patients TW12neg, two independent factors remained highly predictive of SVR by MV analysis (p <= 0.001): genotype 2/3 (odds ratio = 2.9), fibrosis estimated with FT (4.3) or by biopsy (1.5). Conclusions: FibroTest at baseline is a possible non-invasive alternative to biopsy for the prediction of EVR at 12 weeks and SVR, in patients with previous failures and advanced fibrosis, retreated with PEG-IFN alfa-2b and ribavirin. (C) 2010 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Subject: Hepatitis C
Non-responder
Relapser
Cirrhosis
Fibrosis
Biomarkers, Treatment failure
Early virologic response
Country: Holanda
Editor: ELSEVIER SCIENCE BV
Rights: fechado
Identifier DOI: 10.1016/j.jhep.2010.06.038
Address: http://apps.isiknowledge.com/InboundService.do?Func=Frame&product=WOS&action=retrieve&SrcApp=EndNote&UT=000287070400008&Init=Yes&SrcAuth=ResearchSoft&mode=FullRecord
http://dx.doi.org/10.1016/j.jhep.2010.06.038
Date Issue: 2011
Appears in Collections:FCM - Artigos e Outros Documentos

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