Re-treatment of patients with chronic hepatitis C in clinical practice: Results of a multicenter retrospective survey [Ritrattamento dei pazienti con epatite cronica da HCV nella pratica clinica: Risultati di uno studio multicentrico retrospettivo]

Aims. To evaluate in a multicentric retrospective study, carried out at 35 Italian hospitals, the retreatment with interferon (IFN) or interferon-ribavirin (RBV) association in patients with chronic hepatitis C that were non-responder (NR) or responder-relapser (RR) at a previous IFN treatment. Methods. Complete descriptive data of 531 patients were collected from all participant centers by a centralized database (HEPANET). The evaluation of retreatments was done on 256 patients that had completed it on 31 December, 1999. Individuals with no viral genotype data, and those lost for adverse reactions and drop-outs, were excluded from the analysis. Univariate and multivariate statistical analyses were done to evaluate biochemical and virological response, to determine the presence of independent factors of response, and to compare different retreatment strategies. Results. A sustained biochemical response (SBR) was achieved in 30.1% of cases, and a sustained virological response (SVR) in 22.8%. Previous treatment outcome (RR instead of NR), RBV association, and duration of retreatment were independent factors of response. A better efficacy of a 12 months retreatment with IFN alone was confirmed. With the latter, high SVR rates, comparable to IFN+RBV 6 months course, were obtained, both in RR and NR patients. Conclusions. Retrospective multicentric study, as our is, could be a more reliable representation of results obtained in common clinical practice. They may give useful information, together with meta-analyses and randomized studies, for a better cost/benefit evaluation of retreatments in patients with hepatitis C (RR and NR).