A Lower Serum Gamma-Glutamyltransferase Level Does Not Predict a Sustained Virological Response in Patients with Chronic Hepatitis C Genotype 1
0
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: Low gamma-glutamyltransferase (GGT) level was shown to be an independent predictor of a sustained virological response (SVR) in chronic hepatitis C. We aimed to determine factors associated with high GGT level, and to evaluate whether low GGT level is an independent predictor of a SVR in chronic hepatitis C genotype 1. Methods: We retrospectively reviewed our data of patients with chronic hepatitis C genotype 1 treated with pegylated interferon-α and ribavirin. Baseline features were compared between patients with normal and high GGT levels. Factors associated with high GGT level and those associated with a SVR were determined by univariate and multivariate analysis. Results: This study included 57 patients. Mean age was 52.28±9.35 years. GGT levels was elevated in 27 patients (47.4%). GGT levels were normal in 63.3% of the patients who achieved a SVR and in 40.7% of those who did not achieve a SVR (p>0.05). By multivariate logistic regression analysis, the presence of cirrhosis (odds ratio [OR], 9.41; 95% confidence interval [CI], 1.08 to 102.61) and female gender (OR, 6.77; 95% CI, 1.23 to 37.20) were significantly associated with high GGT level, and only rapid virological response was associated with a SVR (OR, 8.369; 95% CI, 1.82 to 38.48). Conclusions: Low GGT level does not predict a SVR; however, it may be a predictor of high fibrosis scores.
Abstract
Background/Aims: Low gamma-glutamyltransferase (GGT) level was shown to be an independent predictor of a sustained virological response (SVR) in chronic hepatitis C. We aimed to determine factors associated with high GGT level, and to evaluate whether low GGT level is an independent predictor of a SVR in chronic hepatitis C genotype 1. Methods: We retrospectively reviewed our data of patients with chronic hepatitis C genotype 1 treated with pegylated interferon-α and ribavirin. Baseline features were compared between patients with normal and high GGT levels. Factors associated with high GGT level and those associated with a SVR were determined by univariate and multivariate analysis. Results: This study included 57 patients. Mean age was 52.28±9.35 years. GGT levels was elevated in 27 patients (47.4%). GGT levels were normal in 63.3% of the patients who achieved a SVR and in 40.7% of those who did not achieve a SVR (p>0.05). By multivariate logistic regression analysis, the presence of cirrhosis (odds ratio [OR], 9.41; 95% confidence interval [CI], 1.08 to 102.61) and female gender (OR, 6.77; 95% CI, 1.23 to 37.20) were significantly associated with high GGT level, and only rapid virological response was associated with a SVR (OR, 8.369; 95% CI, 1.82 to 38.48). Conclusions: Low GGT level does not predict a SVR; however, it may be a predictor of high fibrosis scores.
참고문헌 (34)
- Ghany MG, "American Association for the Study of Liver Diseases. Diagnosis, management, and treatment of hepatitis C: an update", Hepatology, 49, pp.1335~1374 (2009)
- Dienstag JL, "American Gastroenterological Association technical review on the management of hepatitis C", Gastroenterology, 130, pp.231~264 (2006)
- Zeuzem S, "Expert opinion on the treatment of patients with chronic hepatitis C", J Viral Hepat, 16, pp.75~90 (2009)
- Escudero A, "Pegylated alpha-interferon-2a plus ribavirin compared with pegylated alpha-interferon-2b plus ribavirin for initial treatment of chronic hepatitis C virus: prospective, non-randomized study", J Gastroenterol Hepatol, 23, pp.861~866 (2008)
- Yu JW, "Predictive value of rapid virological response and early virological response on sustained virological response in HCV patients treated with pegylated interferon alpha-2a and ribavirin", J Gastroenterol Hepatol, 22, pp.832~836 (2007)
- Sporea I, "Outcome of antiviral treatment in patients with chronic genotype 1 HCV hepatitis. A retrospective study in 507 patients", J Gastrointestin Liver Dis, 19, pp.261~264 (2010)
- Ascione A, "Peginterferon alfa-2a plus ribavirin is more effective than peginterferon alfa-2b plus ribavirin for treating chronic hepatitis C virus infection", Gastroenterology, 138, pp.116~122 (2010)
- Shirakawa H, "Pretreatment prediction of virological response to peginterferon plus ribavirin therapy in chronic hepatitis C patients using viral and host factors", Hepatology, 48, pp.1753~1760 (2008)
- Berg T, "Prediction of treatment outcome in patients with chronic hepatitis C: significance of baseline parameters and viral dynamics during therapy", Hepatology, 37, pp.600~609 (2003)
- Cuenca F, "Predictive baseline criteria of primary therapeutic failure in chronic hepatitis C genotype 1", Rev Esp Enferm Dig, 102, pp.234~238 (2010)
- Villela-Nogueira CA, "Gamma-glutamyl transferase (GGT) as an independent predictive factor of sustained virologic response in patients with hepatitis C treated with interferon-alpha and ribavirin", J Clin Gastroenterol, 39, pp.728~730 (2005)
- Grasso A, "Insulin resistance predicts rapid virological response in non-diabetic, non-cirrhotic genotype 1 HCV patients treated with peginterferon alpha-2b plus ribavirin", J Hepatol, 51, pp.984~990 (2009)
- Kau A, "Treatment predictors of a sustained virologic response in hepatitis B and C", J Hepatol, 49, pp.634~651 (2008)
- Rumi MG, "Randomized study of peginterferon-alpha2a plus ribavirin vs peginterferon-alpha2b plus ribavirin in chronic hepatitis C", Gastroenterology, 138, pp.108~115 (2010)
- Bergmann JF, "Gamma-glutamyltransferase and rapid virological response as predictors of successful treatment with experimental or standard peginterferon-alpha-2b in chronic hepatitis C non-responders", Liver Int, 27, pp.1217~1225 (2007)
- Ferenci P, "Predicting sustained virological responses in chronic hepatitis C patients treated with peginterferon alfa-2a (40 KD)", ribavirin, 2005, pp.43, 425~433
- Akuta N, "Predictive factors of early and sustained responses to peginterferon plus ribavirin combination therapy in Japanese patients infected with hepatitis C virus genotype 1b: amino acid substitutions in the core region and low-density lipoprotein cholesterol levels", J Hepatol, 46, pp.403~410 (2007)
- Giannini E, "Increased levels of gammaGT suggest the presence of bile duct lesions in patients with chronic hepatitis C: absence of influence of HCV genotype, HCV-RNA serum levels, and HGV infection on this histological damage", Dig Dis Sci, 46, pp.524~529 (2001)
- Silva IS, "Role of gamma-glutamyl transferase activity in patients with chronic hepatitis C virus infection", J Gastroenterol Hepatol, 19, pp.314~318 (2004)
- Forns X, "Identification of chronic hepatitis C patients without hepatic fibrosis by a simple predictive model", Hepatology, 36(4 Pt 1), pp.986~992 (2002)
- Poynard T, "Effect of treatment with peginterferon or interferon alfa-2b and ribavirin on steatosis in patients infected with hepatitis C", Hepatology, 38, pp.75~85 (2003)
- AlQaraawi AM, "Prevalence and impact of hepatic steatosis on the response to antiviral therapy in Saudi patients with genotypes 1 and 4 chronic hepatitis C", Dig Dis Sci, 56, pp.1222~1228 (2011)
- Hwang SJ, "Clinical, virological, and pathological significance of hepatic bile duct injuries in Chinese patients with chronic hepatitis C", J Gastroenterol, 36, pp.392~398 (2001)
- Plebani JG, "Combined effects of alcohol and hepatitis C: a secondary analysis of alcohol use biomarkers and high-risk behaviors from two medication trials for alcohol dependence", Addict Behav, 35, pp.123~128 (2010)
- Thabut D, "Noninvasive prediction of fibrosis in patients with chronic hepatitis C", Hepatology, 37, pp.1220~1221 (2003)
- Parise ER, "Noninvasive serum markers in the diagnosis of structural liver damage in chronic hepatitis C virus infection", Liver Int, 26, pp.1095~1099 (2006)
- Wai CT, "A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C", Hepatology, 38, pp.518~526 (2003)
- Sterling RK, "Development of a simple noninvasive index to predict significant fibrosis in patients with HIV", HCV coinfection, 2006, pp.43, 1317~1325
- Vallet-Pichard A, "FIB-4: an inexpensive and accurate marker of fibrosis in HCV infection. comparison with liver biopsy and fibrotest", Hepatology, 46, pp.32~36 (2007)
- Knobler H, "TNF-{alpha}, chronic hepatitis C and diabetes: a novel triad", QJM, 98, pp.1~6 (2005)
- Romero-Gomez M, "Insulin resistance and hepatitis C", World J Gastroenterol, 12, pp.7075~7080 (2006)
- Friedman LS, "Laboratory evaluation of the patient with liver disease, In Hepatology: a textbook of liver disease. Volume 2. 4th ed", pp.661~708 (2003), Saunders
- Mazzella G, "Treatment of chronic sporadic-type non-A, non-B hepatitis with lymphoblastoid interferon: gamma GT levels predictive for response", Dig Dis Sci, 39, pp.866~870 (1994)
- Mihm S, "Preferential virological response to interferon-alpha 2a in patients with chronic hepatitis C infected by virus genotype 3a and exhibiting a low gamma-GT", ALT ratio, 1996, pp.41, 1256~1264
