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Treatment optimization and prediction of HCV clearance in patients with acute HCV infection.
- Source :
-
Journal of hepatology [J Hepatol] 2013 Aug; Vol. 59 (2), pp. 221-8. Date of Electronic Publication: 2013 Apr 12. - Publication Year :
- 2013
-
Abstract
- Background & Aims: The lack of consensus on the optimal timing, regimen, and duration of treatment, in patients with acute HCV infection, stimulates the research on both favourable outcome predictors and individualized treatment regimens. This study aimed at investigating the impact of IL28B SNP rs12979860 alone or in combination with HLA class II alleles in both predicting spontaneous viral clearance and individualizing treatment strategies for patients with HCV persistence, after acute HCV exposure.<br />Methods: 178 patients with AHC, consecutively treated with interferon alone or in combination with ribavirin, starting within or after 48 weeks from the diagnosis of AHC, were tested for IL28B SNPs and HLA class II alleles.<br />Results: Spontaneous viral clearance was achieved in 28% of 169 patients available for genetic testing. Factors associated with HCV elimination were jaundice (OR 2.75, 95% CI 1.31-5.77) and IL28B CC (OR 3.87, CI 1.71-8.51), but not HLA alleles. In CT/TT patients without jaundice, NPV for virus persistence was 98%. In patients with IL28B CT/TT, starting treatment 48 weeks after the onset was significantly associated with lower rates of response (28% vs. 100%, p=0.027). By contrast, no significant differences in the rate of SVR were observed for CC carriers who started treatment later (65% vs. 85%, p=1.0).<br />Conclusions: In patients with acute HCV hepatitis, lack of viral clearance may be predicted by absence of jaundice and IL28B CT/TT genotype; in patients with these characteristics, treatment needs to be started immediately.<br /> (Copyright © 2013. Published by Elsevier B.V.)
- Subjects :
- Acute Disease
Adult
Antiviral Agents therapeutic use
Cohort Studies
Female
Gene Frequency
Genes, MHC Class II
Genotype
HLA-DQ beta-Chains genetics
HLA-DRB1 Chains genetics
Hepatitis C immunology
Humans
Interferons
Jaundice drug therapy
Jaundice virology
Male
Middle Aged
Precision Medicine
Viral Load drug effects
Viral Load genetics
Viral Load immunology
Hepatitis C drug therapy
Hepatitis C genetics
Interleukins genetics
Polymorphism, Single Nucleotide
Subjects
Details
- Language :
- English
- ISSN :
- 1600-0641
- Volume :
- 59
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 23587473
- Full Text :
- https://doi.org/10.1016/j.jhep.2013.04.007