Japanese
researchers explored such factors in a study described in the March 2007 Journal
of Hepatology. The investigators previously showed that amino acid substitutions
in the HCV core region predicted lack of virological
response to pegylated interferon plus ribavirin.
•
70% of treated patients
achieved EVR and 45% achieved SVR. •
64% of subjects who
experienced EVR went on to achieve SVR. •
No patients without
EVR achieved SVR. •
A multivariate analysis
identified the following factors as significant predictors of EVR:
- low-density
lipoprotein cholesterol (LDL) level (above or below 86 mg/dL); - amino acid
substitutions in the HCV core region (double wild-type; arginine at position 70/leucine
at position 91); - gamma-glutamyl transpeptidase (GGT) < 109 IU/L; -
ribavirin dose (above or below 11.0 mg/kg); - leukocyte count (above or below
4500 cells/mm3).
•
Factors significantly
associated with SVR were:
- amino acid substitutions in the HCV core region
(double wild-type); - LDL cholesterol (over or below 86 mg/dL); - male sex; -
indocyanine green dye retention rate (ICG R15) (< 10%); - GGT < 109 IU/L; -
ribavirin dose (above or below 11.0mg/kg).
Conclusion
In
conclusion, the authors wrote, "Our study identified amino acid substitutions
in the core region and serum LDL cholesterol as predictors of response to pegylated
interferon/ribavirin therapy in Japanese patients infected with HCV genotype 1b."
Prediction
of response to therapy based on a combination of these factors had high sensitivity,
specificity, and positive and negative predictive values.
02/27/07
Reference N
Akuta, F Suzuki, Y Kawamura, and others. Predictive factors of early and sustained
responses to peginterferon plus ribavirin combination therapy in Japanese patients
infected with hepatitis C virus genotype 1b: Amino acid substitutions in the core
region and low-density lipoprotein cholesterol levels. Journal of Hepatology
46(3): 403-410. March 2007.
