title: Prediction of a null response to pegylated interferon α-2b plus ribavirin in patients with high viral load genotype 1b hepatitis C.
abstract: OBJECTIVE
  The present study aimed to clarify whether virological response within 2 weeks after therapy initiation can predict a null response to pegylated interferon α-2b plus ribavirin therapy in patients with high viral load genotype 1b hepatitis C.
  
  
  METHODS
  The participants consisted of 72 patients with high viral load genotype 1b. The dynamics of viral load within 2 weeks were measured.
  
  
  RESULTS
  Significant differences between null responders and nonnull responders were noted for interleukin (IL)-28B genotype, amino acid 70 substitution, α-fetoprotein, low-density lipoprotein cholesterol, hyaluronic acid, and viral response. The area under the curve (AUC) for the receiver operating characteristic curve of the hepatitis C virus (HCV) RNA level decline at 2 weeks (AUC=0.993) was the highest among the factors predicting the null response. When the cutoff value for the HCV RNA level decline at 2 weeks was set at 0.80 log, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in predicting a null response were 82%, 96%, 82%, 96%, and 94%, respectively. In comparison, values for the non-TT and mutant type of amino acid 70 substitution were similar to those for HCV RNA level decline at 2 weeks.
  
  
  CONCLUSIONS
  Virological response at 2 weeks or the combination of IL-28B and amino acid 70 substitution are accurate predictors of a null response.
authors: Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors: Yuki
authors: Y
authors: Wada
authors: Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors: Hideyuki
authors: H
authors: Tamai
authors: Department of Internal Medicine, Naga Municipal Hospital, Kinokawa, Japan.
authors: Akira
authors: A
authors: Kawashima
authors: Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors: Naoki
authors: N
authors: Shingaki
authors: Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors: Yoshiyuki
authors: Y
authors: Mori
authors: Department of Gastroenterology, Saiseikai Wakayama Hospital, Wakayama, Japan.
authors: Masanori
authors: M
authors: Kawaguchi
authors: Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors: Kosaku
authors: K
authors: Moribata
authors: Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors: Hisanobu
authors: H
authors: Deguchi
authors: Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors: Kazuki
authors: K
authors: Ueda
authors: Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors: Izumi
authors: I
authors: Inoue
authors: Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors: Takao
authors: T
authors: Maekita
authors: Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors: Mikitaka
authors: M
authors: Iguchi
authors: Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors: Jun
authors: J
authors: Kato
authors: Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
authors: Masao
authors: M
authors: Ichinose
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage*; D019540:Area Under Curve; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D019698:Hepatitis C, Chronic / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D007279:Injections, Subcutaneous; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D008297:Male; D055118:Medication Adherence; D011092:Polyethylene Glycols / Q000008:administration & dosage*; D011446:Prospective Studies; D012367:RNA, Viral / Q000378:metabolism; D011994:Recombinant Proteins / Q000008:administration & dosage; D012254:Ribavirin / Q000008:administration & dosage*; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b
keywords: Amino acid substitution; Hepatitis C virus; Peginterferon alfa-2b; Ribavirin; Single nucleotide polymorphisms