Mutations in the Interferon Sensitivity Determining Region and Virological Response to Combination Therapy with Pegylated-interferon Alpha 2b Plus Ribavirin in Patients with Chronic Hepatitis C-1b Infection

Overview

Journal J Gastroenterol

Specialty Gastroenterology

Date 2010 Jan 30

PMID 20112032

Citations 8

Authors

Mina Nakagawa

Naoya Sakamoto

Mayumi Ueyama

Kaoru Mogushi

Satoshi Nagaie

Yasuhiro Itsui

Seishin Azuma

Sei Kakinuma

Hiroshi Tanaka

Nobuyuki Enomoto

Mamoru Watanabe

Affiliations

Soon will be listed here.

Abstract

Background: Pegylated-interferon-alpha 2b (PEG-IFN) plus ribavirin (RBV) therapy is currently the de-facto standard treatment for hepatitis C virus (HCV) infection. The aims of this study were to analyze the clinical and virological factors associated with a higher rate of response in patients with HCV genotype 1b infection treated with combination therapy.

Methods: We analyzed, retrospectively, 239 patients with chronic hepatitis C-1b infection who received 48 weeks of combination therapy. We assessed clinical and laboratory parameters, including age, gender, pretreatment hemoglobin, platelet counts, HCV RNA titer, liver histology, the number of interferon sensitivity determining region (ISDR) mutations and substitutions of the core amino acids 70 and 91. Drug adherence was monitored in each patient. We carried out univariate and multivariate statistical analyses of these parameters and clinical responses.

Results: On an intention-to-treat (ITT) analysis, 98 of the 239 patients (41%) had sustained virological responses (SVRs). Patients with more than two mutations in the ISDR had significantly higher SVR rates (P<0.01). Univariate analyses showed that stage of fibrosis, hemoglobin, platelet counts, ISDR mutations, serum HCV RNA level, and adherence to PEG-IFN plus RBV were significantly correlated with SVR rates. Multivariate analysis in subjects with good drug adherence extracted the number of ISDR mutations (two or more: odds ratio [OR] 5.181).

Conclusions: The number of mutations in the ISDR sequence of HCV-1b (>or=2) is the most effective parameter predicting a favorable clinical outcome of 48-week PEG-IFN plus RBV therapy in patients with HCV genotype 1b infection.

Citing Articles

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