The Predictive Factors for Favorable Outcomes of Peginterferon and Ribavirin Combination Therapy in HCV-Infected Patients
-
Javad Moayedi
,
Tayebeh Hashempour
,
Zahra Musavi
,
Behzad Dehghani
,
Zahra Hasanshahi
,
Shahin Merat
Abstract
We aimed to investigate the association of pretreatment host and/or viral related factors with sustained virological response (SVR) rate in chronic hepatitis C (CHC) infected patients. This cohort study was performed on 200 IFN-naïve Iranian CHC patients who were treated with pegylated interferon-α (PEG-IFN-α) plus ribavirin (RBV). Pretreatment levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), fasting blood sugar (FBS), HCV load and genotype were determined, and the pattern of changes was monitored throughout the course of treatment. The baseline FBS value in the non-responder group was significantly higher than that of the SVR group. The SVR group showed a rapid and continuous decline of ALT/AST activity from the beginning of the treatment, while the ALT level was fluctuating in non-responder and relapse groups. Persistent normalization of transaminases during combination antiviral therapy was significantly associated with SVR rate. Besides, age and FBS levels had the greatest impact on SVR. Minocycline seems to be a safe and effective adjuvant in the management of patients with schizophrenia.
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2. Hashempoor T, Bamdad T, Merat S, Janzamin E, Nemati L, Jabbari H, et al. Expansion of CD4^ sup+^ CD25^ sup+^ FoxP3^ sup+^ Regulatory T Cells in Chronic Hepatitis C Virus Infection. Iran J Immunol. 2010;7(3):177-85.
3. Alborzi A, Hashempour T, Moayedi J, Musavi Z, Pouladfar G, Merat S. Role of serum level and genetic variation of IL-28B in interferon responsiveness and advanced liver disease in chronic hepatitis C patients. Med Microbiol Immunol. 2017;206(2):165-74.
4. Ajorloo M, Bamdad T, Hashempour T, Alborzi AM, Mozhgani SHR, Asadi R, et al. Detection of Specific Antibodies to HCV-ARF/CORE+ 1 Protein in Cirrhotic and Non-Cirrhotic Patients with Hepatitis C: A Possible Association with Progressive Fibrosis. Arch Iran Med. 2015;18(5):304-7.
5. Chen MY, Liu CH, Chen TC, Su TH, Chen PJ, Chen DS, et al. Value of interleukin‐28B genetic polymorphism on retreatment outcomes of chronic hepatitis C genotype 1 relapsers by peginterferon alfa plus ribavirin. J Gastroenterol Hepatol. 2014;29(1):102-9.
6. Sefidi FJ, Keyvani H, Monavari SH, Alavian SM, Fakhim S, Bokharaei-Salim F. Distribution of hepatitis C virus genotypes in Iranian chronic infected patients. Hepat Mon. 2013;13(1):e7991.
7. Alavian S-M, Adibi P, Zali M-R. Hepatitis C virus in Iran: Epidemiology of an emerging infection. Arch Iran Med. 2005;8(2):84-90.
8. Merat S, Rezvan H, Nouraie M, Jafari E, Abolghasemi H, Radmard AR, et al. Seroprevalence of hepatitis C virus: the first population-based study from Iran. Int J Infect Dis. 2010;14(3):113-6.
9. Wirth S, Ribes-Koninckx C, Calzado MA, Bortolotti F, Zancan L, Jara P, et al. High sustained virologic response rates in children with chronic hepatitis C receiving peginterferon alfa-2b plus ribavirin. J Hepatol. 2010;52(4):501-7.
10. Saludes V, Bracho MA, Valero O, Ardèvol M, Planas R, González-Candelas F, et al. Baseline prediction of combination therapy outcome in hepatitis C virus 1b infected patients by discriminant analysis using viral and host factors. PLoS One. 2010;5(11):e14132.
11. Lin K-H, Yu H-C, Hsu P-I, Tsai W-L, Chen W-C, Lin C-K, et al. Baseline high viral load and unfavorable patterns of alanine aminotransferase change predict virological relapse in patients with chronic hepatitis C genotype 1 or 2 obtaining rapid virological response during antiviral therapy. Hepat Mon. 2013;13(10):e11892.
12. Heidar S. IL28B polymorphism, explanation for different responses to therapy in hepatitis C patients. Hepat Mon. 2011;2011(12):958-9.
13. Tseng C-W, Chen C-Y, Chang T-T, Tzeng S-J, Hsieh Y-H, Hung T-H, et al. Peginterferon alfa-2a is associated with elevations in alanine aminotransferase at the end of treatment in chronic hepatitis C patients with sustained virologic response. PLoS One. 2014;9(6):e100207.
14. Saludes V, Bascuñana E, Jordana-Lluch E, Casanovas S, Ardèvol M, Soler E, et al. Relevance of baseline viral genetic heterogeneity and host factors for treatment outcome prediction in hepatitis C virus 1b-infected patients. PLoS One. 2013;8(8):e72600.
15. Kim YJ, Jang BK, Kim ES, Park KS, Cho KB, Chung WJ, et al. Rapid normalization of alanine aminotransferase predicts viral response during combined peginterferon and ribavirin treatment in chronic hepatitis C patients. Korean J Hepatol. 2012;18(1):41-7.
16. Thompson A, Devine S, Kattan M, Muir A. Prediction of treatment week eight response & sustained virologic response in patients treated with boceprevir plus peginterferon alfa and ribavirin. PLoS One. 2014;9(8):e103370.
17. Alborzi AM, Bamdad T, Davoodian P, Hashempoor T, Nejatizadeh AA, Moayedi J. Insights into the role of HCV Plus-/Minus strand RNA, IFN-γ and IL-29 in relapse outcome in patients infected by HCV. Asian Pac J Allergy Immunol. 2015;33(3):173-81.
18. Basso M, Giannini EG, Torre F, Blanchi S, Savarino V, Picciotto A. Elevations in alanine aminotransferase levels late in the course of antiviral therapy in hepatitis C virus RNA–negative patients are associated with virological relapse. Hepatology. 2009;49(5):1442-8.
19. HUNG CH, LEE CM, LU SN, WANG JH, TUNG HD, CHEN TM, et al. Is delayed normalization of alanine aminotransferase a poor prognostic predictor in chronic hepatitis C patients treated with a combined interferon and ribavirin therapy? J Gastroenterol Hepatol. 2002;17(12):1307-11.
20. Lai M, Afdhal NH. Clinical utility of interleukin‐28B testing in patients with genotype 1. Hepatology. 2012;56(1):367-72.
21. Dogan UB, Akin MS, Yalaki S. Alanine aminotransferase normalization at week 8 predicts viral response during hepatitis C treatment. World J Gastroenterol. 2013;19(46):8678–86.
22. Zeuzem S, Feinman SV, Rasenack J, Heathcote EJ, Lai M-Y, Gane E, et al. Peginterferon alfa-2a in patients with chronic hepatitis C. N Engl J Med. 2000;343(23):1666-72.
23. Elgouhari HM, Zein CO, Hanouneh I, Feldstein AE, Zein NN. Diabetes mellitus is associated with impaired response to antiviral therapy in chronic hepatitis C infection. Dig Dis Sci. 2009;54(12):2699-705.
24. Rao GA, Pandya PK. Statin therapy improves sustained virologic response among diabetic patients with chronic hepatitis C. Gastroenterology. 2011;140(1):144-52.
25. Aziz H, Raza A, Waheed Y, Gill U, Gill ML. Analysis of variables and interactions among variables associated with a sustained virological response to pegylated interferon alfa-2a plus ribavirin in hepatitis C virus genotype 3-infected patients. Int J Infect Dis. 2012;16(8):597-602.
26. Namazee N, Sali S, Asadi S, Shafiei M, Behnava B, Alavian S. Real response to therapy in chronic hepatitis C virus patients: a study from iran. Hepat Mon. 2012;12(9):e6151.
2. Hashempoor T, Bamdad T, Merat S, Janzamin E, Nemati L, Jabbari H, et al. Expansion of CD4^ sup+^ CD25^ sup+^ FoxP3^ sup+^ Regulatory T Cells in Chronic Hepatitis C Virus Infection. Iran J Immunol. 2010;7(3):177-85.
3. Alborzi A, Hashempour T, Moayedi J, Musavi Z, Pouladfar G, Merat S. Role of serum level and genetic variation of IL-28B in interferon responsiveness and advanced liver disease in chronic hepatitis C patients. Med Microbiol Immunol. 2017;206(2):165-74.
4. Ajorloo M, Bamdad T, Hashempour T, Alborzi AM, Mozhgani SHR, Asadi R, et al. Detection of Specific Antibodies to HCV-ARF/CORE+ 1 Protein in Cirrhotic and Non-Cirrhotic Patients with Hepatitis C: A Possible Association with Progressive Fibrosis. Arch Iran Med. 2015;18(5):304-7.
5. Chen MY, Liu CH, Chen TC, Su TH, Chen PJ, Chen DS, et al. Value of interleukin‐28B genetic polymorphism on retreatment outcomes of chronic hepatitis C genotype 1 relapsers by peginterferon alfa plus ribavirin. J Gastroenterol Hepatol. 2014;29(1):102-9.
6. Sefidi FJ, Keyvani H, Monavari SH, Alavian SM, Fakhim S, Bokharaei-Salim F. Distribution of hepatitis C virus genotypes in Iranian chronic infected patients. Hepat Mon. 2013;13(1):e7991.
7. Alavian S-M, Adibi P, Zali M-R. Hepatitis C virus in Iran: Epidemiology of an emerging infection. Arch Iran Med. 2005;8(2):84-90.
8. Merat S, Rezvan H, Nouraie M, Jafari E, Abolghasemi H, Radmard AR, et al. Seroprevalence of hepatitis C virus: the first population-based study from Iran. Int J Infect Dis. 2010;14(3):113-6.
9. Wirth S, Ribes-Koninckx C, Calzado MA, Bortolotti F, Zancan L, Jara P, et al. High sustained virologic response rates in children with chronic hepatitis C receiving peginterferon alfa-2b plus ribavirin. J Hepatol. 2010;52(4):501-7.
10. Saludes V, Bracho MA, Valero O, Ardèvol M, Planas R, González-Candelas F, et al. Baseline prediction of combination therapy outcome in hepatitis C virus 1b infected patients by discriminant analysis using viral and host factors. PLoS One. 2010;5(11):e14132.
11. Lin K-H, Yu H-C, Hsu P-I, Tsai W-L, Chen W-C, Lin C-K, et al. Baseline high viral load and unfavorable patterns of alanine aminotransferase change predict virological relapse in patients with chronic hepatitis C genotype 1 or 2 obtaining rapid virological response during antiviral therapy. Hepat Mon. 2013;13(10):e11892.
12. Heidar S. IL28B polymorphism, explanation for different responses to therapy in hepatitis C patients. Hepat Mon. 2011;2011(12):958-9.
13. Tseng C-W, Chen C-Y, Chang T-T, Tzeng S-J, Hsieh Y-H, Hung T-H, et al. Peginterferon alfa-2a is associated with elevations in alanine aminotransferase at the end of treatment in chronic hepatitis C patients with sustained virologic response. PLoS One. 2014;9(6):e100207.
14. Saludes V, Bascuñana E, Jordana-Lluch E, Casanovas S, Ardèvol M, Soler E, et al. Relevance of baseline viral genetic heterogeneity and host factors for treatment outcome prediction in hepatitis C virus 1b-infected patients. PLoS One. 2013;8(8):e72600.
15. Kim YJ, Jang BK, Kim ES, Park KS, Cho KB, Chung WJ, et al. Rapid normalization of alanine aminotransferase predicts viral response during combined peginterferon and ribavirin treatment in chronic hepatitis C patients. Korean J Hepatol. 2012;18(1):41-7.
16. Thompson A, Devine S, Kattan M, Muir A. Prediction of treatment week eight response & sustained virologic response in patients treated with boceprevir plus peginterferon alfa and ribavirin. PLoS One. 2014;9(8):e103370.
17. Alborzi AM, Bamdad T, Davoodian P, Hashempoor T, Nejatizadeh AA, Moayedi J. Insights into the role of HCV Plus-/Minus strand RNA, IFN-γ and IL-29 in relapse outcome in patients infected by HCV. Asian Pac J Allergy Immunol. 2015;33(3):173-81.
18. Basso M, Giannini EG, Torre F, Blanchi S, Savarino V, Picciotto A. Elevations in alanine aminotransferase levels late in the course of antiviral therapy in hepatitis C virus RNA–negative patients are associated with virological relapse. Hepatology. 2009;49(5):1442-8.
19. HUNG CH, LEE CM, LU SN, WANG JH, TUNG HD, CHEN TM, et al. Is delayed normalization of alanine aminotransferase a poor prognostic predictor in chronic hepatitis C patients treated with a combined interferon and ribavirin therapy? J Gastroenterol Hepatol. 2002;17(12):1307-11.
20. Lai M, Afdhal NH. Clinical utility of interleukin‐28B testing in patients with genotype 1. Hepatology. 2012;56(1):367-72.
21. Dogan UB, Akin MS, Yalaki S. Alanine aminotransferase normalization at week 8 predicts viral response during hepatitis C treatment. World J Gastroenterol. 2013;19(46):8678–86.
22. Zeuzem S, Feinman SV, Rasenack J, Heathcote EJ, Lai M-Y, Gane E, et al. Peginterferon alfa-2a in patients with chronic hepatitis C. N Engl J Med. 2000;343(23):1666-72.
23. Elgouhari HM, Zein CO, Hanouneh I, Feldstein AE, Zein NN. Diabetes mellitus is associated with impaired response to antiviral therapy in chronic hepatitis C infection. Dig Dis Sci. 2009;54(12):2699-705.
24. Rao GA, Pandya PK. Statin therapy improves sustained virologic response among diabetic patients with chronic hepatitis C. Gastroenterology. 2011;140(1):144-52.
25. Aziz H, Raza A, Waheed Y, Gill U, Gill ML. Analysis of variables and interactions among variables associated with a sustained virological response to pegylated interferon alfa-2a plus ribavirin in hepatitis C virus genotype 3-infected patients. Int J Infect Dis. 2012;16(8):597-602.
26. Namazee N, Sali S, Asadi S, Shafiei M, Behnava B, Alavian S. Real response to therapy in chronic hepatitis C virus patients: a study from iran. Hepat Mon. 2012;12(9):e6151.
| Files | ||
| Issue | Vol 58, No 5 (2020) | |
| Section | Articles | |
| DOI | https://doi.org/10.18502/acta.v58i5.3954 | |
| Keywords | ||
| Hepatitis C virus (HCV) Sustained virological response Predictive marker | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Moayedi J, Hashempour T, Musavi Z, Dehghani B, Hasanshahi Z, Merat S. The Predictive Factors for Favorable Outcomes of Peginterferon and Ribavirin Combination Therapy in HCV-Infected Patients. Acta Med Iran. 2020;58(5):214-220.
