Outcome and Early Viral Dynamics with Viral Mutation in PEG-IFN/RBV Therapy for Chronic Hepatitis in Patients with High Viral Loads of Serum HCV RNA Genotype 1b

Abstract

We investigated whether sustained virological response (SVR) and non-SVR by chronic hepatitis C patients to pegylated interferon plus ribavirin (PEG-IFN/RBV) combination therapy are distinguishable by viral factors such as the IFN/RBV resistance-determining region (IRRDR) and by on-treatment factors through new indices such as the rebound index (RI). The first RI (RI-1st; the viral load at week 1 divided by the viral load at 24 h) and the second RI (RI-2nd; the viral load at week 2 divided by the viral load at 24 h) were calculated. The subject patients were divided into 3 groups based on RI-1st and RI-2nd: an RI-A group (RI-1st ≤1.0), an RI-B group (RI-1st >1.0 and RI-2nd <0.7) and an RI-C group (RI-1st >1.0 and RI-2nd ≧0.7). The SVR rate was 71.4% (10/14) in the RI-A group, 46.2% (6/13) in the RI-B group and 20.0% (3/15) in the RI-C group (p = 0.005 between the RI-A group and the RI-C group). In IRRDR ≧6 and IRRDR ≤5 the SVR rate was 81.3% (13/16) and 23.1% (6/26) (p = 0.0002), respectively. By combining RI and IRRDR as a predicting factor, the SVR rate was 87.5% (7/8) in the RI-A group (≧6 mutations in the IRRDR) and 7.7% (1/13) in the RI-C group (≤5 IRRDR mutations) (p = 0.0003).

Evaluation of Treatment Results of Patients with Chronic Hepatitis C Followed for Five Years

“…İlaç vücuda injekte edildikten sonra aktif PEG IFN-α 2b halini alır. PEG IFN-α 2b'nin, nispeten daha kısa bir yarılanma ömrü vardır ve dozun vücut ağırlığına göre ayarlanması gerekir (8,9).…”

Sequence heterogeneity of NS5A and core proteins of hepatitis C virus and virological responses to pegylated-interferon/ribavirin combination therapy

“…The degree of sequence variation within the IRRDR has been proposed as a useful predictor of HCV treatment outcome (11, 15, 20, 21). We performed ROC curve analysis to estimate the optimal cutoff number of IRRDR mutations that differentiated between a SVR and non‐SVR in the present patient cohort.…”

Viral Hepatitis A to E: An Update in 2010

“…Sasase et al [7] investigated whether SVR and non-SVR by chronic hepatitis C patients to PEG-IFN/RBV combination therapy are distinguishable by viral factors such as the IFN/RBV resistance-determining region (IRRDR) and by on-treatment factors through new indices such as the rebound index (RI). The first RI (RI-1st: the viral load at week 1 divided by the viral load at 24 h) and the second RI (RI-2nd: the viral load at week 2 divided by the viral load at 24 h) were calculated, and the subject patients were divided into 3 groups based on RI1st and RI-2nd: an RI-A group (RI-1st ^ 1.0), an RI-B group (RI-1st 1 1.0 and RI-2nd !…”

“…Therefore, IRRDR combined with RIs is the quite promising predictor for SVR and non-SVR. With the aid of RIs and IRRDR, a more effective PEG-IFN/RBV treatment could be within reach [7] .…”