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Platelet count is associated with sustained virological response rates in treatments for chronic hepatitis C

Korean Journal of Internal Medicine 2019년 34권 5호 p.989 ~ 997
 ( Jun Baek-Gyu ) - University of Ulsan College of Medicine Gangneung Asan Hospital Department of Internal Medicine

 ( Park Eui-Ju ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine
 ( Lee Woong-Cheul ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine
 ( Jang Jae-Young ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine
 ( Jeong Soung-Won ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine
 ( Kim Young-Don ) - University of Ulsan College of Medicine Gangneung Asan Hospital Department of Internal Medicine
 ( Cheon Gab-Jin ) - University of Ulsan College of Medicine Gangneung Asan Hospital Department of Internal Medicine
 ( Cho Young-Sin ) - Soonchunhyang University Cheonan Hospital Department of Internal Medicine
 ( Lee Sae-Hwan ) - Soonchunhyang University Cheonan Hospital Department of Internal Medicine
 ( Kim Hong-Soo ) - Soonchunhyang University Cheonan Hospital Department of Internal Medicine
 ( Lee Yun-Nah ) - SoonChunHyang University Bucheon Hospital Department of Internal Medicine
 ( Kim Sang-Gyune ) - Soonchunhyang University Bucheon Hospital Department of Internal Medicine
 ( Kim Young-Seok ) - Soonchunhyang University Bucheon Hospital Department of Internal Medicine
 ( Kim Boo-Sung ) - Soonchunhyang University Seoul Hospital Department of Internal Medicine

Abstract


Background/Aims: This study was conducted to clarify the sustained virological response (SVR) prediction ability of baseline and treatment-related factors in patients with chronic hepatitis C virus (HCV) infection.

Methods: This retrospective study collected data at four tertiary referral hospitals between June 2004 and July 2012. Out of 476 patients, 330 treatment-naive patients with chronic HCV infection were recruited. Pegylated interferon α-2a/- 2b plus ribavirin was administered for either 24 or 48 weeks depending on the HCV genotype. The baseline and treatment-related predictive factors of SVR were evaluated by analyzing data measured before treatment (i.e., baseline) and during treatment.

Results: SVR rates for genotypes 1 and 2 were 63% (97/154) and 79.5% (140/176), respectively (p = 0.001). Multivariate analysis for baseline factors revealed that young age (p = 0.009), genotype 2 (p = 0.001), HCV RNA level of < 800,000 IU/mL (p < 0.001), and a baseline platelet count of > 150 × 103 /μL (p < 0.001) were significant SVR predictors, regardless of the genotype. In particular, predictive accuracy for achievement of SVR was 87.3% for a baseline platelet count of > 150 × 103 /μL. In multivariate analysis for treatment-related factors, SVR was associated with achievement of a rapid virological response (RVR; p < 0.001), treatment adherence of ≥ 80/80/80 (p < 0.001).

Conclusions: Young age, genotype 2, low HCV RNA level, RVR, and treatment adherence were significantly associated with SVR. In addition, platelet count was an independent predictive factor for SVR. Therefore, platelet count could be used to develop individualized treatment regimens and to optimize treatment outcomes in patients with chronic HCV infection.

키워드

Hepatitis C, chronic; Sustained virological response; Blood platelets; Predictor
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