Factors associated with treatment interruption for Hepatitis C.

OBJECTIVE: To evaluate risk factors related to Hepatitis C treatment interruption. METHODS: Retrospective cohort of patients seen at the Hepatology outpatient service at Hospital dos Servidores do Estado do Rio de Janeiro, from 2001 to 2009. The factors investigated were: age, gender, genotype, degree of liver fibrosis, type of treatment, treatment time in weeks, diabetes mellitus, and systemic hypertension. Survival curves and bivariate and multivariate Cox regression models were used in the analyses. RESULTS: The risk of treatment interruption is six times greater in patients with more advanced degrees of liver fibrosis (F4) compared to those with less advanced degree (F2) in the period from 0 to 24 weeks of treatment. Genotype was found to be an important factor to explain therapy cessation after 24 weeks of treatment - the risk of stopping treatment was 2.5 times higher in patients with genotype 3 than in those with genotype 1. CONCLUSION: Degree of liver fibrosis and genotype proved to be the main risk factors associated to treatment interruption.

Factors associated with treatment interruption for hepatitis C

Objective To evaluate risk factors related to Hepatitis C treatment interruption. Methods Retrospective cohort of patients seen at the Hepatology outpatient service at Hospital dos Servidores do Estado do Rio de Janeiro, from 2001 to 2009. The factors investigated were: age, gender, genotype, degree of liver fibrosis, type of treatment, treatment time in weeks, diabetes mellitus, and systemic hypertension. Survival curves and bivariate and multivariate Cox regression models were used in the analyses. Results The risk of treatment interruption is six times greater in patients with more advanced degrees of liver fibrosis (F4) compared to those with less advanced degree (F2) in the period from 0 to 24 weeks of treatment. Genotype was found to be an important factor to explain therapy cessation after 24 weeks of treatment – the risk of stopping treatment was 2.5 times higher in patients with genotype 3 than in those with genotype 1. Conclusion Degree of liver fibrosis and genotype proved to be the main risk factors associated to treatment interruption. .

Objetivo avaliar os fatores de risco relacionados à interrupção do tratamento da hepatite C. Métodos coorte histórica dos pacientes atendidos no ambulatório de Hepatologia do Hospital dos Servidores do Estado do Rio de Janeiro, de 2001 a 2009. Os fatores investigados foram: idade, sexo, genótipo, grau de fibrose hepática, tipo de tratamento, tempo de tratamento em emanas, diabetes mellitus e hipertensão arterial sistêmica. Curvas de sobrevida e modelos de regressão Cox bivariados e multivariados foram utilizados nas análises. Resultados o risco de interrupção do tratamento é seis vezes maior em pacientes com o grau mais avançado de fibrose hepática (F4) do que naqueles com grau menos avançado (F2), no período de 0 a 24 semanas de ratamento. O genótipo mostrou ser importante fator para explicar a suspensão do tratamento a partir da 24ª semana de tratamento – o risco de interromper o tratamento foi 2,5 vezes maior em pacientes com genótipo 3 do que os com genótipo 1. Conclusão o grau de fibrose hepática e o genótipo mostraram-se os principais fatores de risco associados à interrupção do tratamento. .

Análise comparativa do efeito de resposta ao tratamento da Hepatite C entre o interferon peguilado e interferon-alfa associados à ribavirina em pacientes do HSE-RJ / Comparative analysis of the effect of treatment response of hepatitis C between pegylated interferon and alpha interferon-associated with ribavirin in patients HSE-RJ

A Hepatite C (HC) é um sério problema mundial de saúde pública. Pelas estimativas da Organização Mundial da Saúde, calcula-se que cerca de 3% da população mundial esteja infectada pelo vírus da hepatite C. O tratamento da HC objetiva deter a progressão da doença hepática pela inibição da replicação viral. O objetivo deste estudo foi comparar o efeito de resposta ao tratamento da Hepatite C entre o interferon peguilado (PEGINF) + ribavirina (RBV) e interferon-alfa (INF) + ribavirina (RBV) além de avaliar a relação de fatores de risco, idade, sexo, genótipo, grau de fibrose hepática, tempo de tratamento e comorbidades associadas. Foi realizado levantamento retrospectivo dos prontuários dos pacientes atendidos no ambulatório de Hepatologia do Hospital dos Servidores do Estado do RJ (HSE), de 2001 a 2009. Modelos de regressão logística bivariadas e multivariadas foram utilizados nas análises. Cerca de 85% dos pacientes que trataram por 48 semanas e 15% dos que trataram por 24 semanas tiveram resposta virológica sustentada (RVS) positiva. Cerca de 65% dos pacientes que receberam PEGINF + RBV e 35% dos que receberam INF + RBV tiveram RVS positiva. Os achados deste estudo apontam que o efeito de resposta do tratamento de hepatite C com PEG-INF + RBV é superior ao tratamento com INF + RBV, e que a maior duração do tempo de tratamento também tem influência positiva na RVS. Em relação à interrupção do tratamento houve associação estatisticamente significativa entre o grau de fibrose hepática e a probabilidade de permanecer no tratamento, o risco de interrupção é seis vezes maior com o grau mais avançado de fibrose (F4) em relação ao menos avançado (F2). Também foi encontrado que o risco de interromper o tratamento após as primeiras 24 semanas para pacientes com genótipo 3 foi 2,5 vezes maior do que àqueles pacientes com genótipo 1...

Hepatitis C (HC) is a serious public health problem worldwide. According to estimates by the World Health Organization, about 3% of the world population is infected with hepatits C virus. The objective of treatment of HC is avoid the progression of liver disease by inhibition of viral replication. The aim of this study was to compare the effect of treatment response of hepatitis C between pegylated interferon (PEGINF) + ribavirin (RBV) and interferon-alpha (INF) + ribavirin (RBV) and evaluate the relationship of risk factors, age, gender, genotype, degree of fibrosis, treatment time and comorbidities. We conducted a retrospective study of medical records of patients seen at the clinic of Hepatology, Servants Hospital of the State of Rio de Janeiro (HSE), 2001 to 2009. Data were analyzed using bivariate and multivariate analyzes (logistic regression). About 85% of patients treated for 48 weeks, and 15% of those treated for 24 weeks had sustained virologic response (SVR) positive. About 65% of patients receiving PEGINF + RBV and 35% of those who received INF + RBV had positive RVS. In relation to treatment interruption, the association between the degree of liver fibrosis and the probability of remaining treatment was statistically significant . The risk of interruption is six times higher with more advanced fibrosis degree (F4) than compared to the less advanced fibrosis degree (F2). The risk of stopping treatment after the first 24 weeks for patients with genotype 3 was 2.5 times higher than those patients with genotype 1...