Quasispecies as predictive factor of rapid, early and sustained virological responses in chronic hepatitis C, genotype 1, treated with peginterferon-ribavirin.
BACKGROUND
The relationship between the complexity of the hypervariable region 1 quasispecies of HCV and responsiveness to therapy is not completely clear.


OBJECTIVE
To investigate the importance of quasispecies as a predictive factor of rapid (RVR), early (EVR) and sustained (SVR) virologic response.


METHODS
Prospective analysis of 82 patients with chronic hepatitis C, genotype 1, treated with peginterferon alfa-2a and ribavirin. Quasispecies (SSCP), HCV-RNA and viral load were determined at baseline and 2, 4, 8 and 12 weeks after beginning treatment.


RESULTS
Less fibrosis and lower serum GGT activity were the only predictive factors for EVR. SVR predictive factors were age < or =40 years, viral load < or =600,000IU/mL, and quasispecies < or =5 bands. By logistic regression analysis, the independent factors determining SVR were age (P=0.011), viral load (P=0.027), and quasispecies (P=0.010). Quasispecies and viral load were not predictive factors of RVR. During treatment, quasispecies decreased rapidly in the SVR group. In non-EVR patients, quasispecies were slightly lower up to 8 weeks and then increased.


CONCLUSIONS
Quasispecies are an important predictive factor for SVR, but are no better predictors than viral load. Quasispecies are not predictive factors for RVR or EVR.
Salmerón
Javier
J
Gastroenterology Unit, San Cecilio University Hospital and Ciberehd, Granada, Spain. fsalmero@ugr.es
Casado
Jorge
J
Rueda
Paloma Muñoz de
PM
Lafuente
Victor
V
Diago
Moises
M
Romero-Gómez
Manuel
M
Palacios
Angel
A
León
Josefa
J
Gila
Ana
A
Quiles
Rosa
R
Rodriguez
Luis
L
Ruiz-Extremera
Angeles
A
D000328:Adult; D000367:Age Factors; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D005838:Genotype; D016174:Hepacivirus / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011379:Prognosis; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load; D005723:gamma-Glutamyltransferase / Q000097:blood
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; D005723:gamma-Glutamyltransferase; C100416:peginterferon alfa-2a