HCV viraemia is more important than genotype as a predictor of response to interferon in sicily (Southern Italy)
| Autor: | Salvatore Filiberti, S. Magrin, Carmelo Fabiano, Vito Di Marco, Riccardo Volpes, Piero Luigi Almasio, Mickey S. Urdea, G. Fiorentino, Luigi Pagliaro, Alessandra Vaccaro, Judith C. Wilber, L Marino, Celestino Bonoura, Vincenza Capursi, Oreste Lo Iacono, Antonio Craxì, Fabrizio Gianguzza, Lieven Stuyver |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
Liver Cirrhosis Male Cirrhosis Genotype Hepatitis C virus Molecular Sequence Data Alpha interferon Chronic liver disease medicine.disease_cause Antiviral Agents Prevalence BDNA test medicine Humans Viremia Sicily Interferon alfa Base Sequence Hepatology business.industry Interferon-alpha Alanine Transaminase Hepatitis C Middle Aged medicine.disease Treatment Outcome Liver Chronic Disease Immunology Nucleic Acid Conformation Female business medicine.drug |
| Zdroj: | Journal of Hepatology. 25:583-590 |
| ISSN: | 0168-8278 |
| DOI: | 10.1016/s0168-8278(96)80224-8 |
| Popis: | Background/Aims: To investigate host- and virus-related factors predictive of early and sustained alanine aminotransferase normalization after interferon therapy for HCV-related chronic liver disease, in an area where genotype 1 is highly prevalent. Methods: We studied 100 patients with HCV-RNA positive chronic liver disease (73 chronic hepatitis and 27 cirrhosis) undergoing alpha-interferon treatment. Thirty-four patients had an early response but relapsed, 15 patients remained into sustained response for at least 12 months after therapy, and 51 patients did not respond. Serum HCV-RNA levels were assessed by bDNA (Chiron), and genotype by LiPA (Innogenetics) and by sequencing of the 5′ non-coding region. Results: Mean pre-treatment HCV-RNA level (×10 3 genome equivalents/ml±SD) was lower in sustained responders (3854±7142) than in relapsers (9587±10163) or in non-responders (5709±6618). HCV subtype 1b was highly prevalent (82%), while types 1a, 2a, 3 and 4 were rare (about 5% each). However, the prevalence of 1b was much lower (31 %) under 40 years of age. The prevalence of subtype 1b among sustained responders (74%) was similar to that observed among relapsers (82%) or non-responders (84%), but some nucleotide substitutions in the putative RNA loop of the 5′ non-coding region were seen only among relapsers or non-responders. Multiple logistic regression model showed that early response to interferon was predicted by absence of cirrhosis and a pre-treatment HCV-RNA level below 350. Sustained response to interferon was predicted by pre-treatment HCV-RNA level below 350 and a low fibrosis score. Conclusions: Among patients with hepatitis C from an area where subtype 1b is highly prevalent, absence of cirrhosis and low pre-treatment serum HCV-RNA level are the most important predictors of response to IFN. Some nucleotide substitutions found in the 5′ non-coding region of subtype 1b are associated with non-response or relapse. |
| Databáze: | OpenAIRE |
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