Factors influencing effectiveness
This section gives information on the impact of age, gender ethnicity, body weight and alcohol on treatment effectiveness.
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Age, gender and ethnicity
Antiviral therapy is less effective in patients over the age of 40 and men are less likely than women to achieve a sustained viral response.7, 118, 119 Variations have been observed in the response of patients of different race to antiviral therapy. A meta-analysis of ethnic differences showed that patients of African-American or Hispanic origin had lower SVRs than Caucasian or Asian groups (16% and 24% vs 32% and 59% with genotype 1 achieved SVR).141 1+
Patients should be advised that older age at the time of treatment leads to a lower sustained viral response.
Patients should be advised about the likelihood of sustained viral response according to their ethnic origin.
Body weight
Three systematic reviews report that in patients with CHC whose weight is greater than 75 kg, treatment with a combination of pegylated IFN and ribavirin leads to a lower SVR than in patients weighing less than 75 kg.7, 118, 119 Dosage of pegylated IFN and ribavirin in these studies was given at a cut-off point of 75 kg and not weight related, therefore caution should be taken when extrapolating results. Weight and diet issues are discussed on the Nutrition, supportive care and complementary therapies page. 1+
Alcohol
Treatment studies in patients continuing to use alcohol are limited. Two cohort studies have shown that response rate to standard IFN treatment was inversely proportional to the amount of alcohol ingested.142, 143 A six month abstinence from alcohol did not offset previous lifetime alcohol intake.144 2+
Good practice points
Patients should be advised that drinking alcohol (even in moderation) can reduce the response to treatment with pegylated IFN and ribavirin.
