Prediction of a Null Response to Pegylated Interferon α-2b Plus Ribavirin in Patients with High Viral Load Genotype 1b Hepatitis C
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Background/Aims: The present study aimed to clarifywhether virological response within 2 weeks after therapyinitiation can predict a null response to pegylated interferonα-2b plus ribavirin therapy in patients with high viral loadgenotype 1b hepatitis C. Methods: The participants consistedof 72 patients with high viral load genotype 1b. Thedynamics of viral load within 2 weeks were measured. Results:Significant differences between null responders andnonnull responders were noted for interleukin (IL)-28B genotype,amino acid 70 substitution, α-fetoprotein, low-densitylipoprotein cholesterol, hyaluronic acid, and viral response. The area under the curve (AUC) for the receiver operatingcharacteristic curve of the hepatitis C virus (HCV) RNA leveldecline at 2 weeks (AUC=0.993) was the highest among thefactors predicting the null response. When the cutoff valuefor the HCV RNA level decline at 2 weeks was set at 0.80 log,the sensitivity, specificity, positive predictive value, negativepredictive value, and accuracy in predicting a null responsewere 82%, 96%, 82%, 96%, and 94%, respectively. In comparison,values for the non-TT and mutant type of aminoacid 70 substitution were similar to those for HCV RNA leveldecline at 2 weeks. Conclusions: Virological response at2 weeks or the combination of IL-28B and amino acid 70substitution are accurate predictors of a null response.
Abstract
Background/Aims: The present study aimed to clarifywhether virological response within 2 weeks after therapyinitiation can predict a null response to pegylated interferonα-2b plus ribavirin therapy in patients with high viral loadgenotype 1b hepatitis C. Methods: The participants consistedof 72 patients with high viral load genotype 1b. Thedynamics of viral load within 2 weeks were measured. Results:Significant differences between null responders andnonnull responders were noted for interleukin (IL)-28B genotype,amino acid 70 substitution, α-fetoprotein, low-densitylipoprotein cholesterol, hyaluronic acid, and viral response. The area under the curve (AUC) for the receiver operatingcharacteristic curve of the hepatitis C virus (HCV) RNA leveldecline at 2 weeks (AUC=0.993) was the highest among thefactors predicting the null response. When the cutoff valuefor the HCV RNA level decline at 2 weeks was set at 0.80 log,the sensitivity, specificity, positive predictive value, negativepredictive value, and accuracy in predicting a null responsewere 82%, 96%, 82%, 96%, and 94%, respectively. In comparison,values for the non-TT and mutant type of aminoacid 70 substitution were similar to those for HCV RNA leveldecline at 2 weeks. Conclusions: Virological response at2 weeks or the combination of IL-28B and amino acid 70substitution are accurate predictors of a null response.
참고문헌 (23)
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