Pegylated interferon monotherapy in patients with chronic hepatitis C with low viremia and its relationship to mutations in the NS5A region and the single nucleotide polymorphism of interleukin-28B.
OBJECTIVE
Previous studies have suggested that patients with chronic hepatitis C with a low pretreatment hepatitis C virus (HCV) level have a high sustained virological response (SVR) rate, and that there would be a subpopulation of patients in which HCV can be eradicated with pegylated interferon (PEG IFN) alone without a decrease in SVR. However, the efficacy of PEG IFN monotherapy in patients with low HCV RNA levels is unclear. Several studies have reported that interferon sensitivity-determining region (ISDR) and the single-nucleotide polymorphism (SNP) of interleukin-28B (IL-28B) contribute to IFN response, but these relationships are controversial. The aim of this study was to determine whether the SNP of IL-28B (rs8099917) and amino acid substitutions in the ISDR among patients with low HCV levels affect the response to PEG IFN monotherapy.


METHODS
One hundred and four patients with low-level HCV infection were studied. Low HCV level was defined as 100 KIU/mL or less.


RESULTS
SVR was achieved in 94 patients (92.2%). HCV levels (≤50 KIU/mL) and ISDR (≥2 mutations) were associated with SVR on univariate analysis. The rates of SVR in the patients with IL-28B genotypes TT, TG and GG were 94.5%, 77.8% and 100%, respectively. The G allele tended to be associated with poor response to IFN therapy (P = 0.0623). On multivariate analysis, the ISDR was the factor predictive of SVR (P = 0.004).


CONCLUSIONS
The ISDR is significantly associated with a good response to PEG IFN monotherapy in patients with low HCV levels.
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya.
Kazuhiko
K
Hayashi
Yoshiaki
Y
Katano
Hiroko
H
Masuda
Youji
Y
Ishizu
Teiji
T
Kuzuya
Takashi
T
Honda
Masatoshi
M
Ishigami
Akihiro
A
Itoh
Yoshiki
Y
Hirooka
Isao
I
Nakano
Tetsuya
T
Ishikawa
Fumihiro
F
Urano
Kentaro
K
Yoshioka
Hidenori
H
Toyoda
Takashi
T
Kumada
Hidemi
H
Goto