M. Puoti1, E. Minola2, M.G. Antonini1, C. Baiguera1, D. Manno1, O. Fracassetti3, V. Ravasio3, K. Prestini1, L. Biasi1, F. Suter1, G. Carosi1
1 Department Of Infectious Diseases University Of Brescia, Brescia, Italy;
2 Department Of Infectious Diseases, Ospedali Riuniiti, Bergamo, Italy
Background.
Many studies of hepatitis C combine individuals with HCV genotype 2 (HCVG2) and those with genotype 3 (HCVG3) when reporting results. However important differences in age and ethnicity between these two groups make any comparison unfeasible in most of the published studies
Aims:
To compare clinical characteristics and treatment response of patients infected by HCV genotypes 2 and 3.
Methods:
We included in a retrospective analysis all interferon naïve patients infected by HCV G2 and 3, aged 35-50 yrs and born in the same geographic area; they were selected from a prospective observational cohort of patients treated with pegylated interferons and ribavirin in 2 centers. We used Fisher’s exact test and t Test or Mann-Whitney tests when indicated for comparison of proportions and continuous variables by bivariate analysis. Logistic regression analysis was used for multivariate analysis.
Results
We studied 254 patients (83 HCVG2 & 171 HCVG3). History of Injection Drugs Use [Adjusted Odds Ratio AOR 24 ( 95% Confidence Interval CI 9.5-61.2)], age [AOR 0.90 per year (95% CI 0.83-0.97)] and baseline ALT> 3 x UNL ( AOR 2.2 (95%CI 1.1-4.4) were independently associated with HCV G3 infection in multivariate analysis.
RVR rate was significantly lower in HCV G3 (62% vs 76% p=0.02) and relapse rate significantly higher (13% vs 2.5% p=0.02).
SVR was significantly lower in HCV G3 (80%) than in HCV G2 (94%; p 0.002).
AOR for SVR in HCVG3 vs. G2 was 0.2 (95% CI 0.06-0.61) after adjusting for initial ribavirin dose > 13 mg/Kg [AOR 2.4 (95% CI 1.1-5.3)], 80/80/80 adherence [AOR 5.55 (95% CI 2-15.3)] and RVR [AOR 3.9 (95% CI 1.8-8.6)]. History of IDU, age and ALT > 3x UNL did not modify this association.
Conclusions
Patients infected with HCV G3 have different characteristics and show a lower response to anti HCV treatment than those infected with HCV G2 even if they have the same age range and ethnicity. Thus future studies should avoid combining genotype 2 and 3 patient populations when reporting results. These differences should be taken into account in the definition of guidelines for anti-HCV treatment.
