Rapid normalization of alanine aminotransferase predicts viral response during combined peginterferon and ribavirin treatment in chronic hepatitis C patients

Kim, Yun Jung; Jang, Byoung Kuk; Kim, Eun Soo; Park, Kyung Sik; Cho, Kwang Bum; Chung, Woo Jin

doi:10.3350/kjhep.2012.18.1.41

Cited by 18 publications

(14 citation statements)

References 17 publications

(22 reference statements)

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“…Furthermore, these results are also supported by earlier studies showing no significant differences in overall percentage of sero‐conversion between responders and non‐responders. The differences in AST but not ALT levels found here are also in agreement with a recent report showing that rapid normalization of ALT by 4 weeks after treatment might be an independent significant predictive factor for SVR. Flisiac et al.…”

Section: Discussionsupporting

confidence: 93%

A comparative study of variants of pegylated interferon alpha in treatment of chronic HCV patients

Sabaawy

El-Haggar

El-Bahrawy

et al. 2015

APMIS

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HCV infection presents a vast burden in the regions of high prevalence such as Egypt, where most HCV isolates are genotype 4b. Combined treatment of three variants of pegylated interferon and ribavirin is still the standard of care in Egypt. However, no conclusive data confirming their efficacy are available. Here, 60 chronic HCV patients were randomized for ribavirin plus Peg Intron (PEG-IFNα-2b), Pegasys (PEG-IFNα-2a) or Reiveron Retard (PEG-IFNα-2a). Serum interferon and antibody (Ab) levels were measured, and responses and costs were compared. Serum interferon levels were higher in Pegasys group (1625.1 ng/mL) followed by Reiveron Retard (1076.5 ng/mL), and Peg Intron group (857.72 ng/mL). Moreover, Ab levels were the lowest in Reiveron Retard group (318.4 ng/mL), followed by Peg Intron (439.93 ng/mL), and Pegasys cases (610.83 ng/mL). The best 24-week response rates were detected in the Pegasys group (73.3%), followed by Peg Intron (66.67%), and Reiveron Retard (40%). Treatment with both Pegasys and Peg Intron were most cost-effective. Furthermore, Pegasys was superior in both 6-month response and serum interferon, despite having higher Ab levels (more antigenicity). Our data have notable clinical implications and suggest that Pegasys may be a superior choice of interferon therapy for chronic HCV under low socioeconomic conditions.

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Section: Discussionsupporting

confidence: 93%

A comparative study of variants of pegylated interferon alpha in treatment of chronic HCV patients

Sabaawy

El-Haggar

El-Bahrawy

et al. 2015

APMIS

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“…Other factors that affect liver enzyme levels including concurrent medications and alcohol consumption were not fully explored [14]. Furthermore, our analysis does not take into account genetic polymorphisms that have been shown to affect liver enzyme levels and treatment successes in HCV patients: for example, in HLA-C C2-positive individuals, ALT activity decreases more after treatment than in HLA-C C2-negative individuals [20].…”

Section: Discussionmentioning

confidence: 99%

“…A study on patients receiving Pegylated Interferon (PEG-IFN) and Ribavirin (RBV) combination treatment showed that, in patients with abnormal baseline ALT levels, normalization of ALT levels to 1.5 times the normal by week 4 of treatment was associated with SVR [14]. Another study showed that patients who achieved SVR had significantly lower ALT levels than non-responders [15].…”

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confidence: 99%

Liver enzyme normalization predicts success of Hepatitis C oral direct-acting antiviral treatment

Khan

McGuinty

Corsi

et al. 2017

CIM

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Liver enzyme normalization predicts success of Hepatitis C oral directacting antiviral treatment Abstract Purpose: Monitoring of hepatitis C virus (HCV) treatment response is performed by serial HCV RNA measurements; however, this may not be useful for predicting treatment success or failure with oral direct-acting antiviral agent (DAA) therapies. Liver enzyme levels, which are elevated in chronic HCV and tend to decline on therapy, may serve as a more logistically and economically feasible alternative for monitoring treatment response.Source: The Ottawa Hospital Viral Hepatitis Clinic patients (n=219), receiving interferon-free oral DAA treatments, were assessed for liver enzymes and HCV RNA levels at baseline, week 4 and ≥12 weeks post-treatment. Suppression cut points used for this analysis were ALT ≤ 40U L -1 and AST ≤ 30U L -1 . The primary outcome was week 12 sustained virologic response (SVR). By our analysis, all indicators had strong PPV (>90%) but limited NPV (<25%).Principal findings: Along with week 4 HCV RNA, AST ≤ 30U L -1 and AST:ALT ratio at week 4 were associated with SVR in univariate analysis with similar PPV and NPV to HCV RNA. ALT was not predictive of DAA outcome. In multivariate models, adjusting for cirrhosis and genotype, baseline AST:ALT ratio<0.9 (but none of the week 4 indicators) was significantly associated with SVR.Conclusion: Our analysis suggests that enzyme levels (particularly AST and AST:ALT ratio) provide a viable alternative to HCV RNA, with robust predictive value in determining treatment success of DAA therapies.ORIGINAL RESEARCH

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“…Sustained virologic response (SVR) is predicted by negative HCV RNA at week 4 or 12 of treatment. However, rapid normalization of alanine aminotransferase (ALT) also predicts viral response during treatment in CHC patients 4. Moreover, HCV is related to the onset and progress of lipid metabolism; therefore, total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels are useful factors in terms of predicting the effects of IFN therapy 5…”

Section: Introductionmentioning

confidence: 99%

The impact of pegylated interferon and ribavirin combination treatment on lipid metabolism and insulin resistance in chronic hepatitis C patients

Jung

Kim

et al. 2014

Clin Mol Hepatol

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Background/AimsLipid profile and insulin resistance (IR) are associated with hepatitis C virus (HCV) and may predict the chronic hepatitis C (CHC) treatment response. The aim of this study was to determine the association between CHC treatment response and lipid profile and IR change during treatment.MethodsIn total, 203 CHC patients were reviewed retrospectively between January 2005 and December 2011 at Soon Chun Hyang University Hospital. The lipid profile, homeostasis model for assessment (HOMA) of IR (HOMA-IR), and HOMA of β cells (HOMA-β) were evaluated before interferon plus ribavirin therapy (BTx), at the end of treatment (DTx), and 24 weeks after the end of treatment (ATx).ResultsA sustained virologic response (SVR) was achieved by 81% of all patients (49/60), 60% (n=36) of whom possessed genotype 1, with the remainder being non-genotype-1 (40%, n=24). Apart from age, which was significantly higher in the non-SVR group (SVR, 48.0±11.2 years, mean±SD; non-SVR, 56.6±9.9 years; P<0.01), there were no significant differences in the baseline characteristics between the SVR and non-SVR groups. In the SVR group, low density lipoprotein-cholesterol (LDL-C) had significantly changed at DTx and ATx compared to BTx. In addition, HOMA-IR and HOMA-β were significantly changed at DTx in the SVR group. Among those with a high baseline insulin resistance (HOMA-IR >2.5), HOMA-IR was significantly changed at DTx in the SVR group.ConclusionsLDL-C appears to be associated with HCV treatment in SVR patients. Furthermore, eradication of HCV may improve whole-body IR and insulin hypersecretion, as well as high baseline insulin resistance (HOMA-IR >2.5).

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Rapid normalization of alanine aminotransferase predicts viral response during combined peginterferon and ribavirin treatment in chronic hepatitis C patients

Cited by 18 publications

References 17 publications

A comparative study of variants of pegylated interferon alpha in treatment of chronic HCV patients

A comparative study of variants of pegylated interferon alpha in treatment of chronic HCV patients

Liver enzyme normalization predicts success of Hepatitis C oral direct-acting antiviral treatment

The impact of pegylated interferon and ribavirin combination treatment on lipid metabolism and insulin resistance in chronic hepatitis C patients

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