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A non-invasive fibrosis score predicts treatment outcome in chronic hepatitis C virus infection.

Journal article
Authors Johan Westin
Magdalena Ydreborg
Sara Islam
Åsa Alsiö
Amar P Dhillon
Jean-Michel Pawlotsky
Stefan Zeuzem
Solko W Schalm
Carlo Ferrari
Avidan U Neumann
Kristoffer Hellstrand
Martin Lagging
Published in Scandinavian journal of gastroenterology
Volume 43
Issue 1
Pages 73-80
ISSN 0036-5521
Publication year 2008
Published at Institute of Biomedicine, Department of Infectious Medicine
Pages 73-80
Language en
Links www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Antiviral Agents, therapeutic use, Female, Hepatitis C, Chronic, drug therapy, pathology, Humans, Interferon Alfa-2a, therapeutic use, Liver Cirrhosis, pathology, Male, Retrospective Studies, Ribavirin, therapeutic use, Treatment Outcome
Subject categories Microbiology in the medical area

Abstract

OBJECTIVE: The results of a previous study suggest that an index calculated according to the formula (normalized ASAT x PK-INR) x 100/thrombocyte count (x 10(9)/L; GUCI) may reflect liver fibrosis in patients with chronic hepatitis C virus (HCV) infection. The aims of the present study were (i) to validate the association between the Göteborg University Cirrhosis Index (GUCI) score and liver fibrosis and (ii) to evaluate the utility of this index in predicting the outcome of antiviral treatment. MATERIAL AND METHODS: A total of 269 patients with chronic HCV infection, stratified according to HCV genotype (1/4 versus 2/3) participated in a phase III trial using pegylated interferon alpha-2a and ribavirin (DITTO study). Retrospective analyses of the baseline GUCI scores and assessments of pretreatment liver biopsies using the Ishak protocol were performed. Cut-off GUCI scores were calculated to distinguish patients with a high or low probability of sustained viral response (SVR). RESULTS: Striking associations between GUCI and Ishak fibrosis stages (stages 0-2 versus stages 3-4, p = 0.0002, stages 3-4 versus stages 5-6, p = 0.002) were observed. In patients with genotype 1 or 4, a GUCI score below 0.33 was associated with a rapid viral response to antiviral treatment and an SVR rate of 80%. Ninety-two percent of patients (92/101) with a SVR had a pretreatment GUCI score below 1.11. CONCLUSIONS: Our results suggest that the GUCI score appropriately reflects the stage of liver fibrosis in HCV-infected patients, and predicts initial viral kinetics as well as treatment outcome in patients infected with HCV genotype 1 or 4.

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