| Journal: | Annals of hepatology |
| Database: | PERIÓDICA |
| System number: | 000418476 |
| ISSN: | 1665-2681 |
| Authors: | Peltekian, Kevork M1 Bain, Vincent G2 Lee, Samuel S3 Sherman, Morris4 Cooper, Curtis L5 Yoshida, Eric M6 Marotta, Paul J7 Krajden, Mel8 Balshaw, Robert9 Deschenes, Marc10 |
| Institutions: | 1Queen Elizabeth II Health Sciences Centre, Division of Gastroenterology, Halifax, Nova Scotia. Canadá 2University of Alberta, Division of Gastroenterology, Edmonton, Alberta. Canadá 3University of Calgary, Division of Gastroenterology, Calgary, Alberta. Canadá 4University Health Network, Division of Gastroenterology, Toronto, Ontario. Canadá 5University of Ottawa, Division of Infectious Diseases , Ottawa, Ontario. Canadá 6University of British Columbia, Division of Gastroenterology, Vancouver, Columbia Británica. Canadá 7BC Centre for Disease Control, Toronto, Ontario. Canadá 8British Columbia Centre for Disease Control, Vancouver, Columbia Británica. Canadá 9Syreon Corporation, Vancouver, Columbia Británica. Canadá 10Royal Victoria Hospital, Division of Gastroenterology, Montreal, Quebec. Canadá |
| Year: | 2011 |
| Season: | Jul-Sep |
| Volumen: | 10 |
| Number: | 3 |
| Pages: | 260-269 |
| Country: | México |
| Language: | Inglés |
| Document type: | Artículo |
| Approach: | Analítico, descriptivo |
| English abstract | Current practice guidelines recommend liver biopsy prior to treatment of hepatitis C genotype-1 but not for genotype-2/3; this is based on expert opinion, not on published evidence. Methods. In retrospective analysis of a large trial database prior to the publication of recent guidelines, we compared outcomes in 985 treatment-naïve patients with hepatitis C who did or did not undergo liver biopsy before starting peginterferon alfa-2a plus ribavirin. Results. Physicians elected to treat 141/654 (21.6%) genotype-1 patients and 126/331 (38.1%) genotype-2/3 patients without liver biopsy. There were no differences in baseline characteristics among those with or without pre-treatment liver biopsy, except for female preponderance in genotype-1 patients with liver biopsy. The sustained viral response (SVR) rate was no different amongst genotype-2/3 patients who had a biopsy before treatment with 66.3% SVR vs. 69.8% of those treated without biopsy (p = 0.546), but significantly higher among genotype-1 patients with pre-treatment liver biopsy at 54.6 vs. 44.0% for those treated without a liver biopsy (p = 0.029). In genotype-1 patients with liver biopsy, more patients with cirrhosis had dose adjustments (p = 0.0057) rather than drug discontinuation. There was tendency for earlier discontinuation among patients without pre-treatment liver biopsy. Conclusions. Pre-treatment liver biopsy was associated with better SVR amongst genotype-1 patients. This improvement may reflect ongoing commitment to completing the treatment course by both patient and physician. In genotype-2/3 patients, pre-treatment liver biopsy may not be essential to maximize SVR rates. This study validates the recommendations of the most recent treatment guidelines for hepatitis C |
| Disciplines: | Medicina |
| Keyword: | Gastroenterología, Diagnóstico, Hepatitis crónica, Hepatitis C, Criterios diagnósticos, Guías terapéuticas, Biopsia, Terapia antiviral, Apego al tratamiento, Eventos adversos |
| Keyword: | Gastroenterology, Diagnosis, Chronic hepatitis, Diagnostic criteria, Therapeutic guides, Biopsy, Antiviral therapy, Treatment adherence, Hepatitis C, Adverse events |
| Full text: | Texto completo (Ver PDF) |
