Predictive values of amino acid sequences of the core and NS5A regions in antiviral therapy for hepatitis C: a Japanese multi-center study
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Chronic hepatitis C (CHC) genotype 1b patients with high viral load are resistant to peginterferon (PEG-IFN) and ribavirin (RBV) combination therapy, especially older and female patients.
To elucidate the factors affecting early and sustained viral responses (EVR and SVR), 409 genotype 1b patients CHC with high viral loads who had received 48 weeks of PEG-IFN/RBV therapy were enrolled. The amino acid (aa) sequences of the HCV core at positions 70 and 91 and of the interferon sensitivity determining region (ISDR) were analyzed. Host factors, viral factors, and treatment-related factors were subjected to multivariate analysis.
Male gender, low HCV RNA load, high platelet count, two or more aa mutations of ISDR, and wild type of core aa 70 were independent predictive factors for SVR. In patients with over 80% adherences to both PEG-IFN and RBV, male gender, mild fibrosis stage, and wild type of core aa 70 were independent predictors for SVR.
Independent predictive factors for SVR were: no aa substitution at core aa 70, two or more aa mutations in the ISDR, low viral load, high values of platelet count, mild liver fibrosis and male gender.
KeywordsChronic hepatitis C Peginterferon and ribavirin Core amino acid Interferon sensitivity determining region
Chronic hepatitis C
Rapid viral response
Complete early viral response
Late viral response
End of treatment response
Sustained viral response
Interferon sensitivity determining region
We express our thanks to other members of the Study Group of Optimal Treatment of Viral Hepatitis; Hideyuki Nomura, Shin-Kokura Hospital; Yoshiyuki Ueno, University of Tohoku; Hisataka Moriwaki, Gifu University; Makoto Oketani, Kagoshima University Graduate School of Medical and Dental Sciences; Masataka Seike, Oita University; Hiroshi Yotsuyanagi, The University of Tokyo. This study was supported in part by a Grant-in-Aid from the Ministry of Health, Labor and Welfare, Japan.
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