The Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, Australia.
Hepatology. 2013 Jun;57(6):2124-34. doi: 10.1002/hep.26263. Epub 2013 May 8.
Systemic levels of interferon-gamma-inducible protein-10 (IP-10) are predictive of treatment-induced clearance in chronic hepatitis C virus (HCV). In the present study, factors associated with plasma IP-10 levels at the time of acute HCV detection and the association between IP-10 levels and spontaneous clearance were assessed in three cohorts of acute HCV infection. Among 299 individuals, 245 (181 male, 47 human immunodeficiency virus-positive [HIV+]) were HCV RNA+ at acute HCV detection. In adjusted analysis, factors independently associated with IP-10 levels ≥150 pg/mL (median level) included HCV RNA levels >6 log IU/mL, HIV coinfection and non-Aboriginal ethnicity. Among 245 HCV RNA+ at acute HCV detection, 214 were untreated (n = 137) or had persistent infection (infection duration ≥26 weeks) at treatment initiation (n = 77). Spontaneous clearance occurred in 14% (29 of 214). Individuals without spontaneous clearance had significantly higher mean plasma IP-10 levels at the time of acute HCV detection than those with clearance (248 ± 32 versus 142 ± 22 pg/mL, P = 0.008). The proportion of individuals with spontaneous clearance was 0% (0 of 22, P = 0.048) and 16% (27 of 165) and in those with and without plasma IP-10 levels ≥380 pg/mL. In adjusted analyses, favorable IL28B genotype was associated with spontaneous clearance, while higher HCV RNA level was independently associated with lower odds of spontaneous clearance.
High IP-10 levels at acute HCV detection were associated with failure to spontaneously clear HCV. Patients with acute HCV and high baseline IP-10 levels, particularly >380 pg/mL, should be considered for early therapeutic intervention, and those with low levels should defer therapy for potential spontaneous clearance. (HEPATOLOGY 2013;).
干扰素-γ诱导蛋白-10（IP-10）的全身水平可预测慢性丙型肝炎病毒（HCV）治疗诱导的清除。在本研究中，评估了三组急性 HCV 感染时急性 HCV 检测时血浆 IP-10 水平相关因素和 IP-10 水平与自发清除之间的关系。在 299 名个体中，245 名（181 名男性，47 名 HIV 阳性）在急性 HCV 检测时 HCV RNA+。在调整分析中，与 IP-10 水平≥150pg/mL（中位数水平）独立相关的因素包括 HCV RNA 水平>6logIU/mL、HIV 合并感染和非原住民种族。在 245 名急性 HCV 检测时 HCV RNA+的个体中，214 名未治疗（n=137）或在治疗开始时持续感染（感染持续时间≥26 周）（n=77）。自发性清除发生在 14%（29/214）。与清除的个体相比，没有自发性清除的个体在急性 HCV 检测时的平均血浆 IP-10 水平显著更高（248±32与 142±22pg/mL，P=0.008）。在 IP-10 水平≥380pg/mL 的个体中，有自发性清除的比例分别为 0%（22 人中 0 人，P=0.048）和 16%（165 人中 27 人）。在调整分析中，有利的 IL28B 基因型与自发性清除相关，而较高的 HCV RNA 水平与自发性清除的可能性降低独立相关。
急性 HCV 检测时高 IP-10 水平与 HCV 自发清除失败相关。急性 HCV 患者和高基线 IP-10 水平，特别是>380pg/mL 的患者应考虑早期治疗干预，而低水平患者应推迟治疗以实现潜在的自发性清除。（HEPATOLOGY 2013；）。
