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Assessment of the treatment of chronic hepatitis C in the state of Mato Grosso, central Brazil
de Azevedo, Francisco Kennedy Scofoni Faleiros; de Azevedo, Cassius Clay Scofoni Faleiros & Souto, Francisco José Dutra
Abstract
In Brazil, the treatment of hepatitis C virus (HCV) infection is funded by the national public health system (SUS).
To evaluate treatment results in the state of Mato Grosso, central Brazil, we have consulted the files of the office of
the State Department of Health responsible for supplying such medications. We obtained information on 232 treatments
of 201 patients who underwent treatment in or prior to 2008. The study was conducted by reviewing medical
records, making telephone calls and interviewing the assistant physicians. Thirty-nine patients (19.4%) had cirrhosis
and HCV genotype 1 predominated (64.3%). Excluding patients with comorbidities or treatment without ribavirin
we analysed 175 treatments (sustained virologic response occurred in 32.6% of cases). Twenty-six of these 175 were
retreatments and the sustained virological response (SVR) rate among them was 30.8%; the SVR rate was 32.9%
among those receiving treatment for the first time. The SVR rate of genotype 1 patients was 27.8%, whereas it was
37.5% in non-1 genotype patients. The adjusted multivariate analysis showed association of SVR with the absence
of cirrhosis [odds ratio (OR): 7.7; confidence interval (CI) 95%: 2.5, 33.3], the use of pegylated interferon (OR: 5.8;
CI 95%: 1.5, 21.4), non-1 genotype (OR: 5.3; CI 95%: 1.7, 16.7) and uninterrupted treatment (OR: 9.0; CI 95%: 3.3,
45.4). The SVR rates were similar to those found in other Brazilian studies about HCV, but lower than those found in
national and international clinical trials. These data suggest that the treatments of chronic hepatitis C that are made
available by SUS does not, under normal conditions, work as well as the original controlled studies indicated.
Keywords
chronic hepatitis C - treatment - pegylated interferon - ribavirin - conventional interferon - sustained virological response
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