Skip to main content
×
Home
    • Aa
    • Aa
  • Access
  • Open access

Improved hepatitis C treatment response in younger patients: findings from the UK HCV National Register cohort study

  • H. E. HARRIS (a1), A. COSTELLA (a1), G. AMIRTHALINGAM (a1), G. ALEXANDER (a2), M. E. B. RAMSAY (a1) and N. ANDREWS (a3)
  • DOI: http://dx.doi.org/10.1017/S0950268811002317
  • Published online: 29 November 2011
Abstract
SUMMARY

In a cohort of 272 treatment-naive individuals with chronic hepatitis C infection acquired on a known date who were enrolled in the UK HCV National Register, a progressive improvement in response to treatment was found with the evolution of antiviral therapies from 20% (25/122) for interferon monotherapy to 63% (55/88) for pegylated interferon+ribavirin therapy. Multivariable analysis results showed increasing age to be associated with poorer response to therapy [odds ratio (OR) 0·84, 95% confidence interval (CI) 0·72–0·99, P=0·03] whereas time since infection was not associated with response (OR 0·93, 95% CI 0·44–1·98, P=0·85). Other factors significantly associated with a positive response were non-type 1 genotype (P<0·0001) and combination therapies (P<0·0001). During the first two decades of chronic HCV infection, treatment at a younger age was found to be more influential in achieving a sustained viral response than treating earlier in the course of infection.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Improved hepatitis C treatment response in younger patients: findings from the UK HCV National Register cohort study
      Your Kindle email address
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Improved hepatitis C treatment response in younger patients: findings from the UK HCV National Register cohort study
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Improved hepatitis C treatment response in younger patients: findings from the UK HCV National Register cohort study
      Available formats
      ×
Copyright
The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution-NonCommercial-ShareAlike licence <http://creativecommons.org/licenses/by-nc-sa/2.5/>. The written permission of Cambridge University Press must be obtained for commercial re-use
Corresponding author
*Author for correspondence: Dr H. E. Harris, Clinical Scientist – Epidemiology. Immunisation, Hepatitis and Blood Safety Department, Health Protection Services Colindale, Health Protection Agency, 61 Colindale Avenue, London NW9 5EQ, UK. (Email: helen.harris@hpa.org.uk)
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

4.MJ Sweeting , The burden of hepatitis C in England. Journal of Viral Hepatitis 2007; 14: 570576.

5.JG McHutchison , Interferon alfa-2b alone or in combination with ribavirin as initial treatment for chronic hepatitis C. New England Journal of Medicine 1998; 339: 14851492.

6.T Poynard , Randomised trial of interferon alpha2b plus ribavirin for 48 weeks or for 24 weeks versus interferon alpha2b plus placebo for 48 weeks for treatment of chronic infection with hepatitis C virus. Lancet 1998; 352: 14261432.

7.MP Manns , Peg-interferon alfa-2b plus ribavirin compared with inteferon alfa-2b plus ribavirin for initial treatment of chronic hepatitis C: a randomized trial. Lancet 2001; 358: 958965.

8.MW Fried , Peg-interferon Alfa-2a plus ribavirin for chronic hepatitis C virus infection. New England Journal Medicine 2002; 347: 975982.

12.G Saracco , A randomized 4-arm multicenter study of interferon alfa-2b plus ribavirin in the treatment of patients with chronic hepatitis C relapsing after interferon monotherapy. Hepatology 2002; 36: 959966.

13.RP Myers , T Poynard . Interferon for interferon nonresponding and relapsing patients with chronic hepatitis C. Cochrane Database of Systematic Reviews 2002, Issue 4. Art. No.: CD003617. doi:10.1002/14651858.CD003617.

14.SJ Cheng , Interferon and Ribavirin for patients with chronic hepatitis C who did not respond to previous interferon therapy: a meta-analysis of controlled and uncontrolled trials. Hepatology 2001; 33: 231240.

15. TPoynard , Is an ‘a la carte’ combination interferon alfa-2b plus ribavirin regimen possible for the first line treatment in patients with chronic hepatitis C? Hepatology 2000; 31: 211218.

16.TL Wright . Treatment of patients with hepatitis C and cirrhosis. Hepatology 2002; 36: S185S194.

17.BL Bressler , High body mass index is an independent risk factor for nonresponse to antiviral treatment in chronic hepatitis C. Hepatology 2003; 38: 639644.

18. GRFoster , Treatment of chronic hepatitis C with peg-interferon alfa 2a (40 kD) (PEGASYS®) and ribavirin (COPEGUS®): patient age has a marked influence on the individual estimated probability of achieving a sustained virological response. Hepatology 2003; 38: 246A.

19.HE Harris , The HCV National Register: towards informing the natural history of hepatitis C infection in the UK. Journal of Viral Hepatitis 2000; 7: 420427.

21.E Jaeckel , Treatment of acute hepatitis C with interferon alfa-2b. New England Journal of Medicine 2001; 345: 14521457.

22.MJ Sweeting , Estimated progression rates in three United Kingdom hepatitis C cohorts differed according to method of recruitment. Journal of Clinical Epidemiology 2006; 59: 144152.

23.E Kenny-Walsh . Clinical outcomes after hepatitis C infection from contaminated anti-D immune globulin. New England Journal of Medicine 1999; 340: 12281233.

24. SDittmann , Long-term persistence of hepatitis C virus antibodies in a single source outbreak. Journal of Hepatology 1991; 13: 323327.

26.ML Thoman . The pattern of T lymphocyte differentiation is altered during thymic involution. Mechanisms of Ageing and Development 1995; 82: 155170.

28.Q Ouyang , Reduced IFN-gamma production in elderly people following in vitro stimulation with influenza vaccine and endotoxin. Mechanisms of Ageing and Development 2000; 121: 131137.

29.M Hoare , CD4+ T-lymphocyte telomere length is related to fibrosis stage, clinical outcome and treatment response in chronic hepatitis C virus infection. Journal of Hepatology 2010; 53: 252260.


31.S Kleinman , Survival after transfusion as assessed in a large multistate US cohort. Transfusion 2004; 44: 386390.

32. SJHadziyannis , Peg interferon-alfa2a and ribavirin combination therapy in chronic hepatitis C. A randomised study of treatment duration and ribavirin dose. Annals of Internal Medicine 2004; 140: 346355.

33. TPoynard , Impact of Interferon alfa-2b and ribavirin on progression of liver fibrosis in patients with chronic hepatitis C. Hepatology 2000; 32: 11311137.

34.G Antonucci , The Effect of age on response to therapy with pegylated alpha plus ribavirin in a cohort of patients with chronic HCV hepatitis including subjects older than 65 years. American Journal of Gastroenterology 2007; 102: 13831391.

37. THonda , Efficacy of ribavirin plus interferon- alpha in patients aged ⩾60 years with chronic hepatitis C. Journal of Gastroenterology and Hepatology 2007; 22: 989995.

38.Y Iwasaki , Limitation of combination therapy of interferon and ribavirin for older patients with chronic hepatitis C. Hepatology 2006; 43: 5463.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Type Description Title
UNKNOWN
Supplementary Materials

Harris Supplementary Material 1
Harris Supplementary Material 1

 Unknown (85 KB)
85 KB
UNKNOWN
Supplementary Materials

Harris Supplementary Material 2
Harris Supplementary Material 2

 Unknown (69 KB)
69 KB