Prediction of a Null Response to Pegylated Interferon alpha-2b Plus Ribavirin in Patients with High Viral Load Genotype 1b Hepatitis C.
- Author:
Yuki WADA
1
;
Hideyuki TAMAI
;
Akira KAWASHIMA
;
Naoki SHINGAKI
;
Yoshiyuki MORI
;
Masanori KAWAGUCHI
;
Kosaku MORIBATA
;
Hisanobu DEGUCHI
;
Kazuki UEDA
;
Izumi INOUE
;
Takao MAEKITA
;
Mikitaka IGUCHI
;
Jun KATO
;
Masao ICHINOSE
Author Information
1. Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan. tamahide@wakayama-med.ac.jp
- Publication Type:Original Article ; Multicenter Study
- Keywords:
Hepatitis C virus;
Peginterferon alfa-2b;
Ribavirin;
Single nucleotide polymorphisms;
Amino acid substitution
- MeSH:
Administration, Oral;
Adult;
Aged;
Antiviral Agents/*administration & dosage;
Area Under Curve;
Drug Therapy, Combination;
Female;
Genotype;
Hepatitis C, Chronic/*drug therapy/genetics;
Humans;
Injections, Subcutaneous;
Interferon-alpha/*administration & dosage;
Male;
Medication Adherence;
Polyethylene Glycols/*administration & dosage;
Prospective Studies;
RNA, Viral/metabolism;
Recombinant Proteins/administration & dosage;
Ribavirin/*administration & dosage;
Treatment Outcome;
Viral Load;
Young Adult
- From:Gut and Liver
2014;8(4):421-427
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The present study aimed to clarify whether virological response within 2 weeks after therapy initiation can predict a null response to pegylated interferon alpha-2b plus ribavirin therapy in patients with high viral load genotype 1b hepatitis C. METHODS: The participants consisted of 72 patients with high viral load genotype 1b. The dynamics of viral load within 2 weeks were measured. RESULTS: Significant differences between null responders and nonnull responders were noted for interleukin (IL)-28B genotype, amino acid 70 substitution, alpha-fetoprotein, low-density lipoprotein cholesterol, hyaluronic acid, and viral response. The area under the curve (AUC) for the receiver operating characteristic curve of the hepatitis C virus (HCV) RNA level decline at 2 weeks (AUC=0.993) was the highest among the factors predicting the null response. When the cutoff value for the HCV RNA level decline at 2 weeks was set at 0.80 log, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in predicting a null response were 82%, 96%, 82%, 96%, and 94%, respectively. In comparison, values for the non-TT and mutant type of amino acid 70 substitution were similar to those for HCV RNA level decline at 2 weeks. CONCLUSIONS: Virological response at 2 weeks or the combination of IL-28B and amino acid 70 substitution are accurate predictors of a null response.
