Direct-acting antiviral-based triple therapy on alpha-fetoprotein level in chronic hepatitis C patients.
OBJECTIVE
To investigate the impact of telaprevir-based triple therapy on the serum alpha-fetoprotein (AFP) level of chronic hepatitis C patients.


METHODS
A total of 210 patients with chronic hepatitis C genotype 1 of high viral load (baseline serum hepatitis C virus RNA > 5.0 log10 IU/mL) were divided into two groups by type of treatment: triple therapy with telaprevir, pegylated-interferon-α (PEG-IFNα), and ribavirin (RBV) for 24 wk (n = 88), or dual therapy with PEG-IFNα and RBV for 48 wk (n = 122). The relationship between virological response and the change in the serum AFP level from baseline to 24 wk after the end of treatment was examined.


RESULTS
No significant difference in mean baseline AFP level was found between the triple and dual therapy groups (8.8 ng/mL vs 7.8 ng/mL). Triple therapy produced significant declines in the AFP level in sustained virological response (SVR) and non-SVR patients (7.8 ng/mL at baseline to 3.5 ng/mL at 24 wk after the end of treatment, P < 0.001 and 14.3 ng/mL to 9.5 ng/mL, P = 0.004, respectively). In contrast, dual therapy resulted in a significant decline in AFP level only in SVR patients (4.7 ng/mL to 2.8 ng/mL, P < 0.001), but not in non-SVR patients (10.2 ng/mL to 10.1 ng/mL). Among patients with a high-baseline AFP level (≥ 10 ng/mL), the decline in the AFP level was significantly higher in the triple therapy than in the dual therapy group (15.9 ng/mL vs 1.6 ng/mL, P = 0.037).


CONCLUSIONS
Regardless of virological response, telaprevir-based triple therapy reduced the serum AFP level.
Koji Takayama, Norihiro Furusyo, Eiichi Ogawa, Hiroaki Ikezaki, Motohiro Shimizu, Masayuki Murata, Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 812-8582, Japan.
Koji
K
Takayama
Koji Takayama, Norihiro Furusyo, Eiichi Ogawa, Hiroaki Ikezaki, Motohiro Shimizu, Masayuki Murata, Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 812-8582, Japan.
Norihiro
N
Furusyo
Koji Takayama, Norihiro Furusyo, Eiichi Ogawa, Hiroaki Ikezaki, Motohiro Shimizu, Masayuki Murata, Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 812-8582, Japan.
Eiichi
E
Ogawa
Koji Takayama, Norihiro Furusyo, Eiichi Ogawa, Hiroaki Ikezaki, Motohiro Shimizu, Masayuki Murata, Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 812-8582, Japan.
Hiroaki
H
Ikezaki
Koji Takayama, Norihiro Furusyo, Eiichi Ogawa, Hiroaki Ikezaki, Motohiro Shimizu, Masayuki Murata, Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 812-8582, Japan.
Motohiro
M
Shimizu
Koji Takayama, Norihiro Furusyo, Eiichi Ogawa, Hiroaki Ikezaki, Motohiro Shimizu, Masayuki Murata, Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 812-8582, Japan.
Masayuki
M
Murata
Koji Takayama, Norihiro Furusyo, Eiichi Ogawa, Hiroaki Ikezaki, Motohiro Shimizu, Masayuki Murata, Department of General Internal Medicine, Kyushu University Hospital, Fukuoka 812-8582, Japan.
Jun
J
Hayashi
D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D015536:Down-Regulation; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D007564:Japan; D008297:Male; D008875:Middle Aged; D009842:Oligopeptides / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011446:Prospective Studies; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load; D000509:alpha-Fetoproteins / Q000378:metabolism*
C097353:AFP protein, human; D000998:Antiviral Agents; D015415:Biomarkers; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D009842:Oligopeptides; D012367:RNA, Viral; D011994:Recombinant Proteins; D000509:alpha-Fetoproteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C486464:telaprevir; D000410:Alanine Transaminase; C417083:peginterferon alfa-2b
Chronic hepatitis C; Direct-acting antiviral agents; Hepatocellular carcinoma; Serum alpha-fetoprotein; Telaprevir