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KMID : 1188320140080040421
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Gut and Liver
2014 Volume.8 No. 4 p.421 ~ p.427
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Prediction of a Null Response to Pegylated Interferon α-2b Plus Ribavirin in Patients with High Viral Load Genotype 1b Hepatitis C
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Yuki Wada
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
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Abstract
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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 α-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, α-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.
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KEYWORD
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titis C virus, Peginterferon alfa-2b, Ribavirin, Single nucleotide polymorphisms, Amino acid substitution
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