Infectious Diseases, AIDS and Clinical Immunology Research Center, Tbilisi, Georgia.
Eur J Gastroenterol Hepatol. 2012 Jul;24(7):817-23. doi: 10.1097/MEG.0b013e328353fd11.
The early identification of factors contributing to the successful treatment of hepatitis C infection is important for researchers and clinicians. Studies carried out on the role of an ultrarapid viral response (URVR) for the prediction of a sustained viral response (SVR) have shown its high positive predictive value (PPV). However, data on the combined effect of URVR with IL28B genotypes for the prediction of SVR are lacking. Our aim was to study the role of URVR and IL28B genotypes in the prediction of SVR among patients in Georgia infected with genotype 1.
Of a total of 156 patients enrolled in the study, 143 were included in the final analyses. Viral load testing for monitoring the viral response was carried out at 3, 24, 48, and 72 h and at 1, 2, and 4 weeks after the initiation of treatment. IL28B single nucleotide polymorphisms in rs12979860 were genotyped using real-time PCR methods.
Our study showed that URVR was the earliest treatment predictor among genotype 1 patients harboring the IL28B C/C genotype (PPV-100%). Moreover, the C/C genotype was found to have a high PPV among genotype 1 patients without URVR or a rapid viral response, unlike patients infected with genotype 2 or 3. URVR and IL28B C/C genotypes were not as predictive of an SVR among genotype 2 and 3 patients; however, rapid viral responses were highly predictive of an SVR in these patients.
Our results suggest that testing for IL28B genotypes and viral load at weeks 1 and 2 may improve the ability to predict an SVR among hepatitis C virus genotype 1 patients; this information may be useful to ensure patient compliance with treatment.
对于研究人员和临床医生而言,早期识别有助于丙型肝炎感染成功治疗的因素非常重要。针对超快速病毒学应答(URVR)对持续病毒学应答(SVR)预测作用的研究表明其具有较高的阳性预测值(PPV)。然而,URVR 与 IL28B 基因型联合预测 SVR 的数据尚缺乏。我们旨在研究 URVR 和 IL28B 基因型在格鲁吉亚 1 型感染患者中预测 SVR 的作用。
在这项研究中,共有 156 名患者入组,最终有 143 名患者纳入最终分析。通过病毒载量检测监测病毒应答,在治疗开始后 3、24、48 和 72 小时以及 1、2 和 4 周时进行检测。采用实时 PCR 方法对 IL28B 单核苷酸多态性 rs12979860 进行基因分型。
本研究表明,URVR 是携带 IL28B C/C 基因型的 1 型患者中最早的治疗预测指标(PPV-100%)。此外,与感染 2 型或 3 型的患者不同,在没有 URVR 或快速病毒应答的情况下,C/C 基因型在 1 型患者中具有较高的 PPV。URVR 和 IL28B C/C 基因型对 2 型和 3 型患者的 SVR 预测性不高;然而,快速病毒应答对这些患者的 SVR 具有高度预测性。
我们的结果表明,在第 1 周和第 2 周检测 IL28B 基因型和病毒载量可能会提高预测丙型肝炎病毒 1 型患者 SVR 的能力;这些信息可能有助于确保患者遵守治疗方案。