Systemic and intrahepatic interferon-gamma-inducible protein 10 kDa predicts the first-phase decline in hepatitis C virus RNA and overall viral response to therapy in chronic hepatitis C
✍ Scribed by Galia Askarieh; Åsa Alsiö; Paolo Pugnale; Francesco Negro; Carlo Ferrari; Avidan U. Neumann; Jean-Michel Pawlotsky; Solko W. Schalm; Stefan Zeuzem; Gunnar Norkrans; Johan Westin; Jonas Söderholm; Kristoffer Hellstrand; Martin Lagging; DITTO-HCV; NORDynamIC Study Groups
- Publisher
- John Wiley and Sons
- Year
- 2009
- Tongue
- English
- Weight
- 475 KB
- Volume
- 51
- Category
- Article
- ISSN
- 0270-9139
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✦ Synopsis
High systemic levels of interferon-gamma-inducible protein 10 kDa (IP-10) at onset of combination therapy for chronic hepatitis C virus (HCV) infection predict poor outcome, but details regarding the impact of IP-10 on the reduction of HCV RNA during therapy remain unclear. In the present study, we correlated pretreatment levels of IP-10 in liver biopsies (n ؍ 73) and plasma (n ؍ 265) with HCV RNA throughout therapy within a phase III treatment trial (DITTO-HCV). Low levels of plasma or intrahepatic IP-10 were strongly associated with a pronounced reduction of HCV RNA during the first 24 hours of treatment in all patients (P < 0.0001 and P ؍ 0.002, respectively) as well as when patients were grouped as genotype 1 or 4 (P ؍ 0.0008 and P ؍ 0.01) and 2 or 3 (P ؍ 0.002, and P ؍ 0.02). Low plasma levels of IP-10 also were predictive of the absolute reduction of HCV RNA (P < 0.0001) and the maximum reduction of HCV RNA in the first 4 days of treatment (P < 0.0001) as well as sustained virological response (genotype 1/4; P < 0.0001). To corroborate the relationship between early viral decline and IP-10, pretreatment plasma samples from an independent phase IV trial for HCV genotypes 2/3 (NORDynamIC trial; n ؍ 382) were analyzed. The results confirmed an association between IP-10 and the immediate reduction of HCV RNA in response to therapy (P ؍ 0.006). In contrast, pretreatment levels of IP-10 in liver or in plasma did not affect the decline of HCV RNA between days 8 and 29, i.e., the second-phase decline, or later time points in any of these cohorts. Conclusion: In patients with chronic hepatitis C, low levels of intrahepatic and systemic IP-10 predict a favorable first-phase decline of HCV RNA during therapy with pegylated interferon and ribavirin for genotypes of HCV. (HEPATOLOGY 2010;51:1523-1530.