Selection of more pathogenic hepatitis C virus genotype II during long-term follow-up of interferon-treated patients.
The behavior of hepatitis C virus (HCV) infection with regards to type and number of HCV genotypes (tested with genotype-specific nested polymerase chain reaction) was evaluated in 60 patients with anti-HCV-positive chronic active hepatitis without cirrhosis [17 untreated and 43 subjects undergoing single or repeat courses of interferon (IFN) therapy] during a mean follow-up period of 76 +/- 18 months. In untreated patients (2 genotype I, 6 genotype II, 9 mixed infections) 4 out of 9 mixed infections selected for genotype II at the end of follow-up. Of the 43 treated patients 10 were long-term responders with histological remission, 6 were short-term responders, and 22 did not respond. Fifteen of the latter patients received another course of IFN therapy, and only 3 patients responded. Eight of the 10 responders had infection with a single genotype (4 gt I, 3 gt II, 3 gt III). After IFN therapy, all but 2 patients cleared the HCV infection. The responders to the second IFN course (1 gt I, 1 gt II, 1 gt III) remained viremic. Of the short-term responders, 2/6 patients had genotype II and 4 had a mixed infection (3 gt II +/- I and 1 gt II +/- III); gt III became prevalent in the latter in all but one patient. Of the nonresponders 18/24 had more than one genotype, 5 were genotype II at baseline and one had genotype I. At the end of the follow-up period 15/18 with mixed infection had selected for gt II (P < 0.01 vs. untreated patient).(ABSTRACT TRUNCATED AT 250 WORDS)
Villa
E
E
Chair of Gastroenterology, University of Modena, Italy.
Buttafoco
P
P
Merighi
A
A
Grottola
A
A
Ferretti
I
I
Ferrari
A
A
Callea
F
F
Trande
P
P
Rebecchi
A M
AM
Manenti
F
F
D000328:Adult; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics* / Q000472:pathogenicity*; D006508:Hepatitis Antibodies / Q000097:blood; D006526:Hepatitis C / Q000628:therapy* / Q000821:virology; D018937:Hepatitis C Antibodies; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000235:genetics; D011994:Recombinant Proteins; D012641:Selection, Genetic; D013997:Time Factors
D006508:Hepatitis Antibodies; D018937:Hepatitis C Antibodies; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins