Is serum uric acid a predictive factor of response to IFN-treatment in patients with chronic hepatitis C infection?
Several factors, including metabolic profile, are predictive of response to standard antiviral therapy in patients with chronic hepatitis C. In a retrospective study, it was investigated whether uric acid, involved in metabolic syndrome, could be included. A total of 153 patients (56.2% males; mean age 45.7 +/- 11.3 years) treated with pegylated-interferon and ribavirin were included. Eighty-five were infected with hepatitis C virus (HCV) genotype 1 or 4 and 68 with genotype 2 or 3. Viral load was >1,000,000 IU/ml in 101, < or =1,000,000 IU/ml in 35 and unknown in 17 patients. Ishak fibrosis score was < or =4 in 81, >4 in 15 and unknown in 57 patients. Mean serum uric acid was 5.05 +/- 1.3 mg/dl. Sustained virological response (negative serum HCV-RNA 6 months after treatment cessation) was achieved in 102 patients (67%). In the final logistic model, serum uric acid level > or =5.8 mg/dl (OR = 0.46; 95% CI: 0.30-0.62), viral load (OR = 0.29; 95% CI: 0.09-0.92) and HCV genotype (OR = 0.23; 95% CI: 0.09-0.60) were identified as the most important factors independently influencing clinical outcome. The prognostic role of serum uric acid was confirmed on the sub-sample reporting Ishak fibrosis score (OR = 0.49; 95% CI: 0.28-0.85). Serum uric acid level > or =5.8 mg/dl is predictive of poor response to HCV treatment. Prospective studies are needed to clarify the issue.
Pellicano
Rinaldo
R
Department of Gastro-Hepatology, San Giovanni Battista (Molinette) Hospital, Torino, Italy. rinaldo_pellican@hotmail.com
Puglisi
Giovanni
G
Ciancio
Alessia
A
Balzola
Federico
F
Saracco
Giorgio
G
Ciccone
Giovannino
G
Baldi
Ileana
I
Abate
Maria Lorena
ML
Smedile
Antonina
A
Rizzetto
Mario
M
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D016174:Hepacivirus / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008103:Liver Cirrhosis / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012254:Ribavirin / Q000627:therapeutic use; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood*; D019562:Viral Load
D000998:Antiviral Agents; D014527:Uric Acid; D012254:Ribavirin; D007372:Interferons