Clinical Characteristics and Treatment Outcome of Peginterferon Plus Ribavirin in Patients Infected with Genotype 6 Hepatitis C Virus in Korea: A Multicenter Study
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Background/Aims: Because of the limited geographic distribution, there have been insufficient data regarding hepatitis C virus (HCV) genotype 6 in Korea. This study aimed to investigate the clinical characteristics and available treatment outcomes of patients with genotype 6 HCV in Korea. Methods: From 2004 to 2014, data were collected from Korean patients infected with genotype 6 HCV in eight hospitals. Results: Thirty-two patients had genotype 6 HCV. The median age was 44 years, and 6c was the most common subtype. The baseline median alanine transaminase level was 88 (21 to 1,019) IU/mL, and the HCV RNA level was 1,405,000 (96,500 to 28,844,529) IU/mL. Twenty-five patients were treated with peginterferon (PEG-IFN) and ribavirin. Three follow-up losses occurred. Additionally, 13 patients attained a sustained virologic response (SVR), seven patients relapsed, and two patients exhibited a null response. The SVR rates were 40% and 75% for the 24- and more than 48- week treatments, respectively, and five of the six patients who achieved a rapid virologic response (RVR) attained a SVR. Conclusions: Korean patients infected with genotype 6 HCV are relatively young, and 6c is the most common subtype. When treated with PEG-IFN and ribavirin, the SVR rate was 52%. Similar to other genotypes, a longer duration of treatment and attainment of RVR are important for SVR.
Abstract
Background/Aims: Because of the limited geographic distribution, there have been insufficient data regarding hepatitis C virus (HCV) genotype 6 in Korea. This study aimed to investigate the clinical characteristics and available treatment outcomes of patients with genotype 6 HCV in Korea. Methods: From 2004 to 2014, data were collected from Korean patients infected with genotype 6 HCV in eight hospitals. Results: Thirty-two patients had genotype 6 HCV. The median age was 44 years, and 6c was the most common subtype. The baseline median alanine transaminase level was 88 (21 to 1,019) IU/mL, and the HCV RNA level was 1,405,000 (96,500 to 28,844,529) IU/mL. Twenty-five patients were treated with peginterferon (PEG-IFN) and ribavirin. Three follow-up losses occurred. Additionally, 13 patients attained a sustained virologic response (SVR), seven patients relapsed, and two patients exhibited a null response. The SVR rates were 40% and 75% for the 24- and more than 48- week treatments, respectively, and five of the six patients who achieved a rapid virologic response (RVR) attained a SVR. Conclusions: Korean patients infected with genotype 6 HCV are relatively young, and 6c is the most common subtype. When treated with PEG-IFN and ribavirin, the SVR rate was 52%. Similar to other genotypes, a longer duration of treatment and attainment of RVR are important for SVR.
참고문헌 (32)
- Chao DT, "Systematic review: epidemiology of hepatitis C genotype 6 and its management", Aliment Pharmacol Ther, 34, pp.286~296 (2011)
- World Health Organization, "Guidelines for the screening, care and treatment of persons with hepatitis C infection", World Health Organization, ~ (2014)
- Smith DB, "Expanded classification of hepatitis C virus into 7 genotypes and 67 subtypes: updated criteria and genotype assignment web resource", Hepatology, 59, pp.318~327 (2014)
- Gower E, "Global epidemiology and genotype distribution of the hepatitis C virus infection", J Hepatol, 61(1 Suppl), pp.S45~S57 (2014)
- Korean Association for the Study of the Liver (KASL), "KASL clinical practice guidelines: management of hepatitis C", Clin Mol Hepatol, 22, pp.76~139 (2016)
- Lawitz E, "Sofosbuvir for previously untreated chronic hepatitis C infection", N Engl J Med, 368, pp.1878~1887 (2013)
- Gane EJ, "Efficacy of ledipasvir and sofosbuvir, with or without ribavirin, for 12 weeks in patients with HCV genotype 3 or 6 infection", Gastroenterology, 149, pp.1454~1461.e1 (2015)
- 박상훈, "Efficacy and Tolerability of Peginterferon Alpha Plus Ribavirin in the Routine Daily Treatment of Chronic Hepatitis C Patients in Korea: A Multi-Center, Retrospective Observational Study", Gut and Liver, 6(1), pp.98~106 (2012), 거트앤리버 발행위원회
- Lwin AA, "Hepatitis C virus genotype distribution in Myanmar: predominance of genotype 6 and existence of new genotype 6 subtype", Hepatol Res, 37, pp.337~345 (2007)
- Akkarathamrongsin S, "Geographic distribution of hepatitis C virus genotype 6 subtypes in Thailand", J Med Virol, 82, pp.257~262 (2010)
- Nguyen NH, "Risk factors, genotype 6prevalence, and clinical characteristics of chronic hepatitis C in Southeast Asian Americans", Hepatol Int, 4, pp.523~529 (2010)
- Pybus OG, "Genetic history of hepatitis C virus in East Asia", J Virol, 83, pp.1071~1082 (2009)
- 신승각, "유전자 6형 만성C형간염 환자의 유병률과 위험인자 그리고 임상적 특징: 단일기관 경험", 대한소화기학회지, 65(2), pp.105~111 (2015), 대한소화기학회
- Mun Hyuk Seong, "Clinical and epidemiological characteristics of Korean patients with hepatitis C virus genotype 6", Clinical and Molecular Hepatology, 19(1), pp.45~50 (2013), 대한간학회[DOI]
- Oh HB, "Identification of hepatitis C virus genotype 6 in Korean patients by analysis of 5’ untranslated region using a matrix assisted laser desorption", ionization time of flight-based assay, restriction fragment mass polymorphism, 2008, pp.80, 1712~1719
- Thong VD, "Hepatitis C virus genotype 6: virology, epidemiology, genetic variation and clinical implication", World J Gastroenterol, 20, pp.2927~2940 (2014)
- Tokita H, "Hepatitis C virus variants from Thailand classifiable into five novel genotypes in the sixth (6b), seventh (7c, 7d) and ninth (9b, 9c) major genetic groups", J Gen Virol, 76(Pt 9), pp.2329~2335 (1995)
- Kim YJ, "Population genotyping of hepatitis C virus by matrix-assisted laser desorption", ionization timeof-flight mass spectrometry analysis of short DNA fragments, 2005, pp.51, 1123~1131
- Sohn YH, "Performance evaluation of the Abbott RealTime HCV Genotype II for hepatitis C virus genotyping", Clin Chem Lab Med, 48, pp.469~474 (2010)
- Yang R, "Performance comparison of the versant HCV genotype 2.0 assay (LiPA) and the abbott realtime HCV genotype II assay for detecting hepatitis C virus genotype 6", J Clin Microbiol, 52, pp.3685~3692 (2014)
- Cai Q, "Comparison of three different HCV genotyping methods: core, NS5B sequence analysis and line probe assay", Int J Mol Med, 31, pp.347~352 (2013)
- Wantuck JM, "Review article: the epidemiology and therapy of chronic hepatitis C genotypes 4, 5 and 6", Aliment Pharmacol Ther, 39, pp.137~147 (2014)
- Wang X, "Efficacy and safety of pegylated interferon plus ribavirin therapy for chronic hepatitis C genotype 6: a meta-analysis", PLoS One, 9, pp.e100128~ (2014)
- Lam KD, "Randomized controlled trial of pegylated interferon-alfa 2a and ribavirin in treatment-naive chronic hepatitis C genotype 6", Hepatology, 52, pp.1573~1580 (2010)
- Thu Thuy PT, "A randomized trial of 48 versus 24 weeks of combination pegylated interferon and ribavirin therapy in genotype 6 chronic hepatitis C", J Hepatol, 56, pp.1012~1018 (2012)
- Cai Q, "24 versus 48 weeks of peginterferon plus ribavirin in hepatitis C virus genotype 6 chronically infected patients with a rapid virological response: a non-inferiority randomized controlled trial", PLoS One, 10, pp.e140853~ (2015)
- Nguyen MH, "Higher rate of sustained virologic response in chronic hepatitis C genotype 6 treated with 48 weeks versus 24 weeks of peginterferon plus ribavirin", Am J Gastroenterol, 103, pp.1131~1135 (2008)
- AASLD, "IDSA HCV Guidance Panel", Hepatitis C guidance: AASLDIDSA recommendations for testing, managing, and treating adults infected with hepatitis C virus, 2015, pp.62, 932~954
- European Association for Study of Liver, "EASL recommendations on treatment of hepatitis C 2015", J Hepatol, 63, pp.199~236 (2015)
- Feld JJ, "Sofosbuvir and velpatasvir for HCV genotype 1, 2, 4, 5, and 6 infection", N Engl J Med, 373, pp.2599~2607 (2015)
- Shafran SD, "The hepatitis C genotype 1 paradox: cost per treatment is increasing, but cost per cure is decreasing", Can J Gastroenterol Hepatol, 29, pp.46~48 (2015)
- San Miguel R, "Costeffectiveness analysis of sofosbuvir-based regimens for chronic hepatitis C", Gut, 64, pp.1277~1288 (2015)
