Influence of low-density lipoprotein cholesterol on virological response to telaprevir-based triple therapy for chronic HCV genotype 1b infection.
Elevated serum low-density lipoprotein cholesterol (LDL-C) level has been associated with sustained virological response (SVR) by chronic hepatitis C patients treated with pegylated-interferon (PEG-IFN) α and ribavirin (RBV). The aim of this study was to investigate the relation between the baseline LDL-C level and the treatment outcome from telaprevir (TVR)-based triple therapy. This prospective, multicenter study consisted of 241 treatment-experienced patients infected with HCV genotype 1b. All received 12 weeks of TVR in combination with 24 weeks of PEG-IFNα2b and RBV. The SVR rate was 81.3% (196 of 241) by intention-to-treat analysis. Higher LDL-C level was strongly associated with SVR (P=1.3×10⁻⁸). The area under the receiver operating characteristic curve for predicting SVR was 0.78 and the cutoff value for the LDL-C level at baseline was 95 mg/dL. In multivariable logistic regression analysis of predictors of SVR, LDL-C ≥95 mg/dL (odds ratio [OR] 3.60, P=0.0238), α-fetoprotein ≤5.0 ng/mL (OR 5.06, P=0.0060), prior relapse to PEG-IFNα and RBV (OR 5.71, P=0.0008), and rapid virological response (HCV RNA undetectable at week 4) (OR 5.52, P=0.0010) were extracted as independent predictors of SVR. For prior partial and null responders, the SVR rates of the groups with LDL-C ≥95 mg/dL were significantly higher than those of the <95 mg/dL groups with IL28B TG/GG and pretreatment platelet count <150×10⁹/L (both P<0.05). The baseline LDL-C level exerted a potent influence on the SVR of treatment-experienced patients treated with TVR-based triple therapy, especially for prior partial and null responders to PEG-IFNα and RBV.
Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.
Eiichi
E
Ogawa
Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.
Norihiro
N
Furusyo
Department of Hepatology, Steel Memorial Yawata Hospital, Kitakyushu, Japan.
Eiji
E
Kajiwara
The Center for Liver Disease, Shin-Kokura Hospital, Kitakyushu, Japan.
Hideyuki
H
Nomura
Department of Internal Medicine, Chihaya Hospital, Fukuoka, Japan.
Kazufumi
K
Dohmen
Department of Medicine, Hamanomachi Hospital, Fukuoka, Japan.
Kazuhiro
K
Takahashi
Department of Gastroenterology, Kyushu Medical Center, National Hospital Organization, Fukuoka, Japan.
Makoto
M
Nakamuta
Center for Liver Disease, National Hospital Organization Kokura Medical Center, Kitakyushu, Japan.
Takeaki
T
Satoh
Department of Medicine, Kyushu Central Hospital, Fukuoka, Japan.
Koichi
K
Azuma
Department of Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan.
Akira
A
Kawano
Department of Medicine, Fukuoka City Hospital, Fukuoka, Japan.
Yuichi
Y
Tanabe
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Kazuhiro
K
Kotoh
Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Shinji
S
Shimoda
Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan. Electronic address: hayashij@gim.med.kyushu-u.ac.jp.
Jun
J
Hayashi
D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D008078:Cholesterol, LDL / Q000097:blood*; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000627:therapeutic use*; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome
D000998:Antiviral Agents; D008078:Cholesterol, LDL; D009842:Oligopeptides; C486464:telaprevir
Hepatitis C; IL28B; Low-density lipoprotein cholesterol; Pegylated interferon; Telaprevir