Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan.
J Gastroenterol Hepatol. 2014 Jan;29(1):201-7. doi: 10.1111/jgh.12376.
It is not yet clear which factors are associated with the outcome of 72-week treatment with pegylated-interferon and ribavirin (RBV) in patients with chronic hepatitis C virus (HCV) infection.
In 66 patients with HCV genotype 1 who had a late viral response (LVR) to 72-week treatment of pegylated-interferon and RBV, we examined the factors that determined the outcome, including single nucleotide polymorphisms of interleukin-28B and inosine triphosphatase (ITPA) genes.
Thirty seven of 66 (56%) patients with LVR achieved a sustained viral response (SVR). The mean age of these 37 SVR patients was 55, compared with 61 in 29 relapsed patients (P = 0.009). Twenty six of 54 (48%) patients with the CC genotype and 11 of 12 (92%) with the CA/AA genotype of ITPA rs1127354 achieved SVR (P = 0.006). The SVR rates were 79%, 40%, 60%, and 33% in patients with undetectable HCV RNA on weeks 16, 20, 24, and 28 or later, respectively (P = 0.014). Finally, serum RBV concentration at week 44 of treatment was significantly higher in the SVR group (2651 ng/mL) than in the relapse group (1989 ng/mL, P = 0.002). In contrast, the rate of the interleukin-28B genotype was not different between the groups. Multiple regression analysis showed that age < 60 years, ITPA CA/AA genotype, and serum RBV concentration were significant independent predictive factors for SVR.
Our findings elucidated the association of four factors, including ITPA genotype, with the outcome of 72-week treatment in LVR patients.
慢性丙型肝炎病毒（HCV）感染患者接受聚乙二醇干扰素和利巴韦林（RBV）72 周治疗的结局与哪些因素相关尚不清楚。
在 66 例 HCV 基因 1 型对聚乙二醇干扰素和 RBV 72 周治疗发生晚期病毒学应答（LVR）的患者中，我们检测了决定结局的因素，包括白细胞介素 28B 和肌苷三磷酸酶（ITPA）基因的单核苷酸多态性。
66 例 LVR 患者中，37 例（56%）获得持续病毒学应答（SVR）。37 例 SVR 患者的平均年龄为 55 岁，而 29 例复发患者的平均年龄为 61 岁（P=0.009）。ITPA rs1127354 位点 CC 基因型的 26 例和 CA/AA 基因型的 11 例患者均获得 SVR（P=0.006）。周 16、20、24 和 28 或更晚时 HCV RNA 不可检测的患者 SVR 率分别为 79%、40%、60%和 33%（P=0.014）。最后，治疗第 44 周时血清 RBV 浓度在 SVR 组（2651ng/mL）显著高于复发组（1989ng/mL，P=0.002）。相比之下，两组白细胞介素 28B 基因型的比例无差异。多因素回归分析显示，年龄＜60 岁、ITPA CA/AA 基因型和血清 RBV 浓度是 SVR 的显著独立预测因素。
我们的研究结果阐明了包括 ITPA 基因型在内的四个因素与 LVR 患者 72 周治疗结局的相关性。
