title: Clinical trial: low plasma cholesterol and oxidative stress predict rapid virological response to standard therapy with peginterferon and ribavirin in HCV patients.
abstract: BACKGROUND
  Rapid virological response (RVR) is the best predictor of sustained response to standard HCV treatment.
  
  
  OBJECTIVE
  To evaluate predictive factors of RVR.
  
  
  METHODS
  Sixty-five patients (mean age 52.6 +/- 13.8; 37 genotype-1, and 28 genotypes-2/3) were consecutively treated with pegIFN-alpha 2a or 2b once weekly plus daily ribavirin based on body weight for 24 or 48 weeks, according to genotype. RVR was defined as undetectable HCV-RNA at week 4.
  
  
  RESULTS
  Twenty-seven percent of patients achieved RVR in genotypes 1 and 60.7% in genotypes 2/3 (P < 0.01). Rapid responders had higher mean serum baseline total and LDL-cholesterol levels (P < 0.01). RVR was 20.0% in the bottom tertile of total cholesterol and 63.6% in the top tertile (P < 0.01). HCV-RNA levels at week 4 were positively correlated with baseline serum insulin (P < 0.01), HOMA-IR (P < 0.01), body mass index (P < 0.05) and number of components of metabolic syndrome (P < 0.01) and negatively correlated with cholesterol levels (P < 0.05). At multivariate analysis, age, LDL-cholesterol, HCV genotype and serum 8-iso-PGF 2 alpha, a marker of oxidative stress, were independent predictors of RVR.
  
  
  CONCLUSIONS
  Our prospective study supports a role of low serum total and LDL-cholesterol and of oxidative stress as positive independent predictive factors of poor RVR in HCV patients.
authors.affiliation: Department of Experimental Medicine, Division of Internal Medicine C, Sapienza University, Rome, Italy. Francesco.angelico@uniroma1.it
authors.forename: F
authors.initials: F
authors.lastname: Angelico
authors.forename: S
authors.initials: S
authors.lastname: Francioso
authors.forename: M
authors.initials: M
authors.lastname: Del Ben
authors.forename: K
authors.initials: K
authors.lastname: Feole
authors.forename: M
authors.initials: M
authors.lastname: Carbone
authors.forename: P
authors.initials: P
authors.lastname: Pignatelli
authors.forename: F
authors.initials: F
authors.lastname: Violi
authors.forename: M
authors.initials: M
authors.lastname: Angelico
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D008078:Cholesterol, LDL; D005260:Female; D016174:Hepacivirus / Q000187:drug effects*; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011237:Predictive Value of Tests; D012367:RNA, Viral / Q000097:blood / Q000187:drug effects*; D012254:Ribavirin / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D008078:Cholesterol, LDL; D012367:RNA, Viral; D011092:Polyethylene Glycols; D012254:Ribavirin