Gut Liver.  2014 Jul;8(4):421-427.

Prediction of a Null Response to Pegylated Interferon alpha-2b Plus Ribavirin in Patients with High Viral Load Genotype 1b Hepatitis C

• Wada Y
• Tamai H
• Kawashima
• Shingaki N
• Mori Y
• Kawaguchi
• Moribata K
• Deguchi H
• Ueda K
• Inoue I
• Maekita T
• Iguchi M
• Kato J
• Ichinose M

Abstract

BACKGROUND/AIMS
The present study aimed to clarify whether virological response within 2 weeks after therapy initiation can predict a null response to pegylated interferon alpha-2b plus ribavirin therapy in patients with high viral load genotype 1b hepatitis C.
METHODS
The participants consisted of 72 patients with high viral load genotype 1b. The dynamics of viral load within 2 weeks were measured.
RESULTS
Significant differences between null responders and nonnull responders were noted for interleukin (IL)-28B genotype, amino acid 70 substitution, alpha-fetoprotein, low-density lipoprotein cholesterol, hyaluronic acid, and viral response. The area under the curve (AUC) for the receiver operating characteristic curve of the hepatitis C virus (HCV) RNA level decline at 2 weeks (AUC=0.993) was the highest among the factors predicting the null response. When the cutoff value for the HCV RNA level decline at 2 weeks was set at 0.80 log, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in predicting a null response were 82%, 96%, 82%, 96%, and 94%, respectively. In comparison, values for the non-TT and mutant type of amino acid 70 substitution were similar to those for HCV RNA level decline at 2 weeks.
CONCLUSIONS
Virological response at 2 weeks or the combination of IL-28B and amino acid 70 substitution are accurate predictors of a null response.

Keyword

Hepatitis C virus; Peginterferon alfa-2b; Ribavirin; Single nucleotide polymorphisms; Amino acid substitution

MeSH Terms

Administration, Oral
Adult
Aged
Antiviral Agents/*administration & dosage
Area Under Curve
Drug Therapy, Combination
Female
Genotype
Hepatitis C, Chronic/*drug therapy/genetics
Humans
Injections, Subcutaneous
Interferon-alpha/*administration & dosage
Male
Medication Adherence
Polyethylene Glycols/*administration & dosage
Prospective Studies
RNA, Viral/metabolism
Recombinant Proteins/administration & dosage
Ribavirin/*administration & dosage
Treatment Outcome
Viral Load
Young Adult
Antiviral Agents
Interferon-alpha
Polyethylene Glycols
RNA, Viral
Recombinant Proteins
Ribavirin