Influence of HCV genotype 1 subtypes on the virus response to PEG interferon alpha-2a plus ribavirin therapy

✍ Scribed by F. Nicot; L. Alric; K. Barange; S. Métivier; J.M. Dramard; J.M. Combis; B. Castan; J.J. Meurisse; J.L. Payen; D. Garipuy; H. Desmorat; J.M. Peron; S. Thebault; T. Morin; C. Renou; P. Barel; B. Guerin; Y. Imbert; S. Sire; K. Sauné; E. Chatelut; J. Izopet

• Book ID: 102385965
• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 223 KB
• Volume: 83
• Category: Article
• ISSN: 0146-6615
• DOI: 10.1002/jmv.21976

✦ Synopsis

Abstract

New factors that influence the viral response in HCV non‐genotype 2/3 patients must be identified in order to optimize anti‐HCV treatment. This multicenter prospective study evaluates the influence of HCV variability and pharmacological parameters on the virological response of these patients to pegylated interferon α2a (peg‐IFN‐α2a: 180 µg/week) and ribavirin (RBV; 800–1,200 mg/day) for 48 weeks. HCV subtypes were identified by sequencing the NS5B region. Serum RBV and peg‐IFN‐α2a concentrations were measured at weeks 4 and 12. The 115 patients (67 men; median age = 49, range 31–76) included 64 who had never been treated and 27 co‐infected with HIV. The mean baseline HCV RNA was 6.30 ± 0.06 log IU/ml and the HCV genotypes were: G1 (n = 93) with 1a (n = 37) and 1b (n = 50), G4 (n = 20) and G5 (n = 2). Most patients (79/108; 73%) had an early virological response. Independent predictors of an early virological response were interferon naive patients (OR = 2.98, 95% CI: 1.15–7.72) and RBV of >2,200 ng/ml at week 12 (OR = 3.41, 95% CI: 1.31–8.90). Forty of 104 patients (38%) had a sustained virological response. The only independent predictors of a sustained virological response were subtype 1b (OR = 6.82, 95% CI: 1.7–26.8), and HCV RNA <15 IU/ml at week 12 (OR = 25, 95% CI: 6.4–97.6). Thus a serum RBV concentration of >2,200 ng/ml was associated with an early virological response and patients infected with HCV subtype 1b had a better chance of a sustained virological response than did those infected with subtype 1a. J. Med. Virol. 83:437–444, 2011. © 2011 Wiley‐Liss, Inc.