Methicillin-Resistant Staphylococcus aureus Bloodstream Infections in Hospitalized Patients in Peru.

There is a knowledge gap in the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) causing bloodstream infections (BSIs) in Peru. Through a surveillance study in 13 hospitals of 10 Peruvian regions (2017-2019), we assessed the proportion of MRSA among S. aureus BSIs as well as the molecular typing of the isolates. A total of 166 S. aureus isolates were collected, and 36.1% of them were MRSA. Of note, MRSA isolates with phenotypic and genetic characteristics of the hospital-associated Chilean-Cordobes clone (multidrug-resistant SCCmec I, non-Panton-Valentine leukocidin [PVL] producers) were most commonly found (70%), five isolates with genetic characteristics of community-associated MRSA (CA-MRSA)-SCCmec IV, PVL-producer-(8.3%) were seen in three separate regions. These results demonstrate that hospital-associated MRSA is the most frequent MRSA found in patients with BSIs in Peru. They also show the emergence of S. aureus with genetic characteristics of CA-MRSA. Further studies are needed to evaluate the extension of CA-MRSA dissemination in Peru.

Prevalence of Antimicrobial Resistance in Gram-Negative Bacteria Bloodstream Infections in Peru and Associated Outcomes: VIRAPERU Study.

Surveillance of antimicrobial resistance among gram-negative bacteria (GNB) is of critical importance, but data for Peru are not available. To fill this gap, a non-interventional hospital-based surveillance study was conducted in 15 hospitals across Peru from July 2017 to October 2019. Consecutive unique blood culture isolates of key GNB (Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter spp.) recovered from hospitalized patients were collected for centralized antimicrobial susceptibility testing, along with linked epidemiological and clinical data. A total of 449 isolates were included in the analysis. Resistance to third-generation cephalosporins (3GCs) was present in 266 (59.2%) GNB isolates. Among E. coli (n = 199), 68.3% showed 3GC resistance (i.e., above the median ratio for low- and middle-income countries in 2020 for this sustainable development goal indicator). Carbapenem resistance was present in 74 (16.5%) GNB isolates, with wide variation among species (0% in E. coli, 11.0% in K. pneumoniae, 37.0% in P. aeruginosa, and 60.8% in Acinetobacter spp. isolates). Co-resistance to carbapenems and colistin was found in seven (1.6%) GNB isolates. Empiric treatment covered the causative GNB in 63.3% of 215 cases. The in-hospital case fatality ratio was 33.3% (92/276). Pseudomonas aeruginosa species and carbapenem resistance were associated with higher risk of in-hospital death. In conclusion, an important proportion of bloodstream infections in Peru are caused by highly resistant GNB and are associated with high in-hospital mortality.

Underutilization and Quality Gaps in Blood Culture Processing in Public Hospitals of Peru.

Correct processing of blood cultures may impact individual patient management, antibiotic stewardship, and scaling up of antimicrobial resistance surveillance. To assess the quality of blood culture processing, we conducted four assessments at 16 public hospitals across different regions of Peru. We assessed the following standardized quality indicators: 1) positivity and contamination rates, 2) compliance with recommended number of bottles/sets and volume of blood sampled, 3) blood culture utilization, and 4) possible barriers for compliance with recommendations. Suboptimal performance was found, with a median contamination rate of 4.2% (range 0-15.1%), with only one third of the participating hospitals meeting the target value of < 3%; and a median positivity rate of 4.9% (range 1-8.1%), with only 6 out of the 15 surveilled hospitals meeting the target of 6-12%. None of the assessed hospitals met both targets. The median frequency of solitary blood cultures was 71.9% and only 8.9% (N = 59) of the surveyed adult bottles met the target blood volume of 8 - 12 mL, whereas 90.5% (N = 602) were underfilled. A high frequency of missed opportunities for ordering blood cultures was found (69.9%, 221/316) among patients with clinical indications for blood culture sampling. This multicenter study demonstrates important shortcomings in the quality of blood culture processing in public hospitals of Peru. It provides a national benchmark of blood culture utilization and quality indicators that can be used to monitor future quality improvement studies and diagnostic stewardship policies.

Lepra lepromatosa nodular de diagnóstico tardío procedente de la Amazonía peruana, con el desarrollo de una reacción tipo 2 / Late diagnosis nodular lepromatous leprosy from the Peruvian Amazon, with development of a type 2 reaction

Resumen La lepra o enfermedad de Hansen es una de las clásicas enfermedades olvidadas que aún persiste en Perú. La infección es ocasionada por Mycobacterium leprae. La enfermedad varía en un amplio rango de manifestaciones desde la lepra tuberculoide (paucibacilar) hasta la lepromatosa (multibacilar). Se presenta el caso de un varón de 55 años, agricultor y extractor de madera, procedente de la Amazonia peruana, con lesiones cutáneas antiguas infiltrantes en la cara, cuello, tórax, abdomen y extremidades. La baciloscopia y estudio histológico de una biopsia de piel confirmaron la presencia de bacilos ácido-alcohol resistentes. Se concluyó, en forma tardía, que fue un caso de lepra lepromatosa nodular. Recibió terapia con rifampicina, dapsona y clofamizina por dos años con una lenta mejoría; no obstante, cursó con un eritema nodoso leproso (reacción tipo 2) con buena respuesta a corticoesteroides y talidomida.

Abstract Leprosy or Hansen's disease is one of the classic neglected diseases that still persists in Peru. The infection is caused by Mycobacterium leprae. The disease varies in a wide range of manifestations from tuberculoid (paucibacillary) to lepromatous (multibacillary) leprosy. We present the case of a 55-year-old man, farmer and wood extractor, from the Peruvian Amazon with old infiltrating cutaneous lesions on the face, neck, thorax, abdomen and extremities. The smear and biopsy examinations confirm the presence of acid-alcohol-resistant bacilli compatible with leprosy. It is concluded, with a long delay, it was a case of nodular lepromatous leprosy. He received therapy with rifampicin, dapsone and clofamizine for two years with slow progressive improvement; however, he presented an erythema nodosum leprosum (type 2 reaction) with response to corticosteroids and thalidomide.

Pityriasis rubra pilaris post-infection due COVID-19: case report.

CASE DESCRIPTION: 32-month-old boy, IgG positive for SARS-CoV-2, presented to the emergency department with dermatologic lesions. CLINICAL FINDINGS: Four days before admission, he presented skin eruptions with redness and pruritus on hands and feet. Generalized papular erythema was evidenced, upper extremities with diffuse erythematosquamous plaques, palmoplantar keratoderma, so he was evaluated by a dermatologist who diagnosed pityriasis rubra pilaris. TREATMENT AND OUTCOME: rehydrating cream, cetirizine 0.5 mg/kg/day every two days, and prednisolone 2 mg/kg/day in the morning. He was discharged after 14 days, the patient presented clinical improvement, but the erythematous lesion persisted on the trunk and extremities. In the evaluation, after three months, the patient did not show the described lesions, evidencing an improvement and clinical resolution of the dermatological problems. CLINICAL RELEVANCE: We report a patient with pityriasis rubra piloris associated with a post-infection by SARS-CoV-2 that had not been described before.

Pityriasis rubra pilaris post-infection due COVID-19: case report / Pitiriasis rubra pilaris post-infección por COVID-19: reporte de un caso

Abstract Case description: 32-month-old boy, IgG positive for SARS-CoV-2, presented to the emergency department with dermatologic lesions. Clinical findings: Four days before admission, he presented skin eruptions with redness and pruritus on hands and feet. Generalized papular erythema was evidenced, upper extremities with diffuse erythematosquamous plaques, palmoplantar keratoderma, so he was evaluated by a dermatologist who diagnosed pityriasis rubra pilaris. Treatment and outcome: rehydrating cream, cetirizine 0.5 mg/kg/day every two days, and prednisolone 2 mg/kg/day in the morning. He was discharged after 14 days, the patient presented clinical improvement, but the erythematous lesion persisted on the trunk and extremities. In the evaluation, after three months, the patient did not show the described lesions, evidencing an improvement and clinical resolution of the dermatological problems. Clinical relevance: We report a patient with pityriasis rubra piloris associated with a post-infection by SARS-CoV-2 that had not been described before.

Resumen Descripción del caso: Niño 32 meses de vida, con IgG positivo para SARS-CoV-2, acude al servicio de emergencia por presentar lesiones dermatológicas. Hallazgos clínicos: Cuatro días antes del ingreso presentó erupciones en la piel, con enrojecimiento y prurito en manos y pies. Se evidenció eritema papular generalizado, extremidades superiores con placas eritematoescamosas difusas, queratodermia palmo-plantar por lo que es evaluado por dermatólogo quien diagnostica pitiriasis rubra pilaris. Tratamiento y resultado: Crema rehidratantes, cetirizina 0.5 mg/kg/día cada 2 días y prednisolona 2 mg/kg/día por la mañana. Fue dado de alta a los 14 días, el paciente presenta mejora clínica, pero aún persiste la lesión eritematosa en tronco y extremidades. En la evaluación a los tres meses el paciente no mostró las lesiones descritas, evidenciando una mejoría y resolución clínica de los problemas dermatológicos. Relevancia clínica: Se reporta un paciente con afectación por pitiriasis rubra piloris asociado a una post-infección por SARS-CoV-2 que no se había descrito antes.

[Late diagnosis nodular lepromatous leprosy from the Peruvian Amazon, with development of a type 2 reaction]. / Lepra lepromatosa nodular de diagnóstico tardío procedente de la Amazonía peruana, con el desarrollo de una reacción tipo 2.

Leprosy or Hansen's disease is one of the classic neglected diseases that still persists in Peru. The infection is caused by Mycobacterium leprae. The disease varies in a wide range of manifestations from tuberculoid (paucibacillary) to lepromatous (multibacillary) leprosy. We present the case of a 55-year-old man, farmer and wood extractor, from the Peruvian Amazon with old infiltrating cutaneous lesions on the face, neck, thorax, abdomen and extremities. The smear and biopsy examinations confirm the presence of acid-alcohol-resistant bacilli compatible with leprosy. It is concluded, with a long delay, it was a case of nodular lepromatous leprosy. He received therapy with rifampicin, dapsone and clofamizine for two years with slow progressive improvement; however, he presented an erythema nodosum leprosum (type 2 reaction) with response to corticosteroids and thalidomide.

Nivel de conocimiento en tratamiento de tuberculosis en médicos de la Región Lambayeque / Level of knowledge in tuberculosis treatment among doctors in the Lambayeque Region

Objetivo. Medir el nivel de conocimientos sobre tratamiento de tuberculosis en médicos del primer nivel de atención en la Región Lambayeque. Material y Métodos: Estudio descriptivo, trasversal. Se recolectaron datos en los establecimientos de salud del primer nivel de atención. Tamaño de muestra: se utilizó EPIDAT v 3.1; tamaño poblacional de 221 personas, nivel de confianza 95%, precisión absoluta 5%, proporción esperada de bajo nivel de conocimiento en tratamiento de TBC en médicos del 27%; se obtuvo un tamaño de muestra de 97 participantes. Se incluyeron a 113 médicos seleccionados por muestreo no probabilístico por conveniencia, excluyéndose los que laboren solamente en atención privada y actividades administrativas. Se aplicó un instrumento previamente validado. Se realizó análisis de frecuencias absolutas y relativas para variables cualitativas y media y desviación estándar para variables cuantitativas. Además, el análisis inferencial con Chi2 y ANOVA con p<0,05. Resultados: El 60,2% tienen una experiencia laboral mayor a 5 años; 43,4% atendieron al menos 1 paciente en los últimos 6 meses. Cuando se analizó el nivel de conocimiento se obtuvo como resultado que de los 64/113 médicos encuestados obtuvieron entre 11 y 15 puntos (nivel medio). Conclusiones: El conocimiento más frecuente es nivel medio y bajo en médicos de establecimiento de primer nivel de atención de la región Lambayeque.

Objetive. To measure the level of knowledge about treatment of tuberculosis in doctors of the first level of care in the Lambayeque Region. Material and Methods: Descriptive, cross-sectional study. Data were collected in health facilities at the first level of care. Sample size: EPIDAT v 3.1 was used: population size of 221 persons, 95% confidence level, 5 absolute precision %, An expected low level of knowledge in treatment of TB in physicians of 27%; A sample size of 97 participants was obtained. A total of 113 physicians selected for nonprobabilistic sampling were included for convenience, excluding those who work only in private care and administrative activities. An instrument previously validated. Absolute and relative frequency analyzes were performed for qualitative and mean variables and standard deviation for quantitative variables. In addition, the inferential analysis with Chi2 and ANOVA with p <0.05. Results: 60.2% have a work experience of more than 5 years; 43.4% attended at least 1 patient in the last 6 months. When the level of knowledge was analyzed, it was obtained that of the 64/113 doctors surveyed obtained between 11 and 15 points (average level). Conclusions: The knowledge more frequent is medium and low level in doctors of first level care of the Lambayeque region

[Rapidly fatal septicemic plague secondary to undiagnosed primary bubonic plague: case report]. / Peste septicémica rápidamente fatal secundaria a peste bubónica primaria inicialmente no diagnosticada: reporte de caso.

Plague is a re-emerging disease caused by the bacteria Yersinia pestis. Humans usually get the disease through the bite of an infected flea. Plague is a fulminant systemic disease, with pneumonic plague being the most lethal form. Late diagnosis is one of the main causes of mortality and spread of the disease, as it limits the effectiveness of control measures. We present the case of a 42-year-old male, who had previously traveled to an endemic plague area and then presented hyperpyrexia, hypotension, and inflammatory inguinal adenopathy. Despite the very characteristic clinical picture, nobody (before admission to our hospital) suspected plague. An effective combination of antibiotics and intensive treatment was initiated only on the fifth day of illness. The patient went into septic shock, respiratory failure, and death. Plague was confirmed by polymerase chain reaction (PCR). This case emphasizes the importance of having a high suspicion rate for plague.

La peste es una enfermedad reemergente causada por Yersinia pestis. Los humanos generalmente adquieren la enfermedad por picaduras de pulgas. La peste es una enfermedad sistémica fulminante, siendo la peste neumónica la forma más letal. El diagnóstico tardío es una de las principales causas de mortalidad y diseminación de la enfermedad, dado que limita la efectividad de las medidas de control. Presentamos el caso de un varón de 42 años, que previamente había viajado a una zona endémica de peste, y luego presentó hiperpirexia, hipotensión, y adenopatía inguinal inflamatoria. A pesar del cuadro clínico muy característico, nadie (antes del ingreso a nuestro hospital) sospechó peste. Se inició una combinación antibiótica efectiva y tratamiento intensivo recién al quinto día de enfermedad. El paciente evolucionó con shock séptico, falla respiratoria, y muerte. Se confirmó peste por reacción en cadena de polimerasa (PCR). Este caso enfatiza la importancia de tener un alto índice de sospecha para peste.

Fiebre amarilla selvática con serología positiva para leptospira en un varon joven peruano / Jungle yellow fever with positive serology for leptospira in a young peruvian male

RESUMEN Fiebre amarilla (FA) y leptospirosis son zoonosis endémicas subdiagnosticadas de las regiones tropicales de África y Sudamérica. Ambas, pueden ser clínicamente indistinguibles y presentarse como síndrome febril icterohemorrágico agudo. Reportamos el caso de un varón de 20 años, procedente del departamento de Amazonas que se presentó con nueve días de enfermedad caracterizada por falla multiorgánica (compromiso neurológico, renal, hepático, respiratorio, y hematológico). Recibió tratamiento antibiótico, soporte transfusional, dialítico, hemodinámico, y ventilatorio; y a pesar de la gravedad del cuadro clínico, evolucionó favorablemente. Se confirmó FA por Rt-PCR y se obtuvo serología positiva para leptospira por ELISA y microaglutinación. Sin embargo, no se pudo demostrar, desde el punto de vista laboratorial, coinfección real por FA y leptospira. Este caso de FA severa con desenlace no fatal enfatiza la importancia del diagnóstico sindrómico adecuado, y un tratamiento de soporte precoz y agresivo que puede salvar la vida del paciente.

ABSTRACT Yellow fever (YF) and leptospirosis are under-diagnosed endemic zoonoses of the tropical regions of Africa and South America. Both may be clinically indistinguishable and present as an acute icterohemorrhagic febrile syndrome. We report the case of a 20-year-old male from the department of Amazonas who presented with nine days of disease characterized by multiorgan failure (neurological, renal, hepatic, respiratory, and hematological involvement). He received antibiotic treatment, as well as, transfusion, dialysis, hemodynamic, and ventilatory support. Despite the severity of the clinical condition, he evolved favorably. YF was confirmed by Rt-PCR and positive serology was obtained for leptospira by ELISA and microagglutination. However, from a laboratory point of view, real co-infection by yellow fever and leptospira could not be demonstrated. This case of severe YF with non-fatal outcome emphasizes the importance of adequate syndromic diagnosis, and early and aggressive supportive treatment that can save a patient's life.

Peste septicémica rápidamente fatal secundaria a peste bubónica primaria inicialmente no diagnosticada: reporte de caso / Rapidly fatal septicemic plague secondary to undiagnosed primary bubonic plague: case report

RESUMEN La peste es una enfermedad reemergente causada por Yersinia pestis. Los humanos generalmente adquieren la enfermedad por picaduras de pulgas. La peste es una enfermedad sistémica fulminante, siendo la peste neumónica la forma más letal. El diagnóstico tardío es una de las principales causas de mortalidad y diseminación de la enfermedad, dado que limita la efectividad de las medidas de control. Presentamos el caso de un varón de 42 años, que previamente había viajado a una zona endémica de peste, y luego presentó hiperpirexia, hipotensión, y adenopatía inguinal inflamatoria. A pesar del cuadro clínico muy característico, nadie (antes del ingreso a nuestro hospital) sospechó peste. Se inició una combinación antibiótica efectiva y tratamiento intensivo recién al quinto día de enfermedad. El paciente evolucionó con shock séptico, falla respiratoria, y muerte. Se confirmó peste por reacción en cadena de polimerasa (PCR). Este caso enfatiza la importancia de tener un alto índice de sospecha para peste.

ABSTRACT Plague is a re-emerging disease caused by the bacteria Yersinia pestis. Humans usually get the disease through the bite of an infected flea. Plague is a fulminant systemic disease, with pneumonic plague being the most lethal form. Late diagnosis is one of the main causes of mortality and spread of the disease, as it limits the effectiveness of control measures. We present the case of a 42-year-old male, who had previously traveled to an endemic plague area and then presented hyperpyrexia, hypotension, and inflammatory inguinal adenopathy. Despite the very characteristic clinical picture, nobody (before admission to our hospital) suspected plague. An effective combination of antibiotics and intensive treatment was initiated only on the fifth day of illness. The patient went into septic shock, respiratory failure, and death. Plague was confirmed by polymerase chain reaction (PCR). This case emphasizes the importance of having a high suspicion rate for plague.

[Jungle yellow fever with positive serology for leptospira in a young peruvian male]. / Fiebre amarilla selvática con serología positiva para leptospira en un varon joven peruano.

Yellow fever (YF) and leptospirosis are under-diagnosed endemic zoonoses of the tropical regions of Africa and South America. Both may be clinically indistinguishable and present as an acute icterohemorrhagic febrile syndrome. We report the case of a 20-year-old male from the department of Amazonas who presented with nine days of disease characterized by multiorgan failure (neurological, renal, hepatic, respiratory, and hematological involvement). He received antibiotic treatment, as well as, transfusion, dialysis, hemodynamic, and ventilatory support. Despite the severity of the clinical condition, he evolved favorably. YF was confirmed by Rt-PCR and positive serology was obtained for leptospira by ELISA and microagglutination. However, from a laboratory point of view, real co-infection by yellow fever and leptospira could not be demonstrated. This case of severe YF with non-fatal outcome emphasizes the importance of adequate syndromic diagnosis, and early and aggressive supportive treatment that can save a patient's life.

Fiebre amarilla (FA) y leptospirosis son zoonosis endémicas subdiagnosticadas de las regiones tropicales de África y Sudamérica. Ambas, pueden ser clínicamente indistinguibles y presentarse como síndrome febril icterohemorrágico agudo. Reportamos el caso de un varón de 20 años, procedente del departamento de Amazonas que se presentó con nueve días de enfermedad caracterizada por falla multiorgánica (compromiso neurológico, renal, hepático, respiratorio, y hematológico). Recibió tratamiento antibiótico, soporte transfusional, dialítico, hemodinámico, y ventilatorio; y a pesar de la gravedad del cuadro clínico, evolucionó favorablemente. Se confirmó FA por Rt-PCR y se obtuvo serología positiva para leptospira por ELISA y microaglutinación. Sin embargo, no se pudo demostrar, desde el punto de vista laboratorial, coinfección real por FA y leptospira. Este caso de FA severa con desenlace no fatal enfatiza la importancia del diagnóstico sindrómico adecuado, y un tratamiento de soporte precoz y agresivo que puede salvar la vida del paciente.

Conocimientos sobre fiebre de chikungunya en población de dos distritos con escenario epidemiológico III en Lambayeque, Perú / Knowledge on chikungunya fever in population of two districts with epiemiological scenario III in Lambayeque, Perú

Introducción: La fiebre de Chikungunya ha afectado a millones de personas en el mundo y sigue causando epidemias en varios países. En el Perú hay condiciones que facilitarían la introducción y transmisión del virus ya que 18 regiones de nuestro país tienen al vector entre las que se encuentran Pátapo y Pucalá. Objetivos: Estimar el nivel de conocimientos sobre Fiebre de Chikungunya en pobladores de 2 distritos con escenario epidemiológico III, describir las características socio demográficas de las poblaciones, identificar si existe asociación entre el nivel de conocimientos y las características socio demográficas, describir los conocimientos sobre prevención de fiebre de Chikungunya en la población. Material y métodos: Estudio cuantitativo descriptivo transversal en pobladores de los distritos de Pátapo y Pucalá siendo seleccionados por un muestreo por conglomerados monoetápico aplicándoseles un cuestionario con escala de Guttman que da puntaje de 1-4 y ha sido validado en un estudio del año 2014. Resultados: Se entrevistaron a 726 personas de las cuales un 65,3% obtuvo un nivel deficiente, 31,8% obtuvo un nivel básico, 2,9 obtuvo un nivel intermedio y nadie logro obtener un nivel bueno. Conclusión: El nivel de conocimientos sobre fiebre de Chikungunya en pobladores de los dos distritos con escenario epidemiológico III en su mayoría es deficiente.

Factores predictivos de respuesta al tratamiento contra la Hepatitis C crónica en pacientes atendidos en el Hospital Militar Central, Lima - Perú, 2006-2011 / Predictive factors of response to treatment against Chronic Hepatitis C in patients attended at the Hospital Militar Central, Lima-Peru, 2006-2011

Se realizó un estudio retrospectivo de casos y controles para evaluar los factores predictivos de eficacia del tratamiento combinado con interferón pegilado alfa (Peg IFN alfa) y ribavirina (RBV) contra la hepatitis C crónica en un hospital de Lima Perú, años 2006-2011. Se incluyó 34 casos consecutivos de sujetos con Respuesta Virológica Sostenida (RVS) y 36 controles temporales sin RVS, entre quienes se determinó 16 variables epidemiológicas, clínicas y de tratamiento. Se utilizó el análisis univariado de regresión logística a través del programa estadístico Epi lnfo. Los hallazgos fueron: ninguno de los factores epidemiológicos, como edad, género, procedencia e in gesta alcohólica se relacionó con la RVS; de los factores clínicos evaluados, como: IMC, score Child-Pugh, índice MELD, transaminasemia y grado de fibrosis, solo el estadio Child A (OR=9,45; p<0,05) se relacionó con RVS; y de los factores de tratamiento, la carga viral <= 600 mil Ul/mL (OR=2,68; p<0,05), la Respuesta Virológica Rápida (RVR; OR=58,4; p<0,01), y la Respuesta Virológica Precoz (RVP; OR=14,5; p<0,05) se asociaron con la RVS. En conclusión, los factores predictores de la RVS en los pacientes con terapia para VRC fueron: la enfermedad hepática compensada (Child-Pugh A), la RVP, y sobretodo, la RVR.

We performed a retrospective study of cases and controls to assess predictors of efficacy of combination therapy with pegylated interferon alpha (Peg IFN-a) and ribavirin (RBV) for hepatitis C infection in a hospital in Lima Peru, years 2006-2011. lt included 34 consecutive cases of patients with Sustained Virological Response (SVR) and 36 controls without SVR, among whom was determined 16 variables epidemiological, clinical and treatment. We used univariate logistic regression analysis through statistical program Epi Info. The findings were: none of the epidemiological factors such as age, gender, origin and alcohol intake, were associated with SVR; clinical factors evaluated, as: BMI, Child-Pugh score, MELD index, transaminasemia and degree of fibrosis; only stage Child A (OR=9,45; p<0.05) was associated with SVR, and treatment factors, the load viral <=600 000 IU/ml (OR=2,68; p<0.05), Rapid Virological Response (RVR; OR=58.4; p<0.01), and Early Virological Response (EVR; OR=14,5 ; P<0.05) were associated with SVR. In conclusion, predictors of SVR in patients with HCV therapy were: the compensated liver disease (Child-Pugh A), the RVP, and above all, the RVR.