TORNA ALL’ELENCO

HCV genotype 1a and 1b: Similarities and differences in clinical features, therapeutic outcome and predictor of response in Hepatology

2013
AOU Città della Salute di Torino

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (21)Vedi tutti...

Morisco F

Andriulli A

Di Marco V


et alii...

Abstract

Aim: to evaluate the baseline similarities and differences between the two HCV-1 subtypes, 1a vs 1b, on pre-treatment and on-treatment predictors of response to peg-interferon and ribavirin. Patients and methods: A total of 1184 naïve patients with HCV genotype-1 infection were treated with PEG-IFN ?-2a or ?-2b in combination with daily ribavirin (1000-1200 mg/day). A total of 15 centers in Italy, selected by voluntary participation between January 2005 and December 2010, took part into the study. The study included 155 (13%) patients infected with subtype 1a (M/F 114/41, median age 47 yrs, range 18-78) and 1029 (87%) patients infected with subtype 1b (M/F 574/455, median age 57 yrs, range 18-84). Results: At multivariate analysis, the baseline characteristics differentiating patients with genotype 1a vs 1b were younger age (<50 yrs) and male sex, being more frequently observed in genotype 1a.Of note, the IL28B polymorphisms and the RVR resulted equally distributed between the two HCV 1 subtype. SVR was achieved by 38% of genotype 1b and by 45% of genotype 1a even in this difference of 7% is not statistically significant. At the multivariate analysis of pre-treatment and on-treatment predictors of SVR, three factors were independently associated in subtype 1a: female gender (OR = 2.829, CI: 1.146-6.983), IL28B polymorphism (OR = 5.216, CI: 1.765-15.410), and RVR (OR = 5.066, CI: 1.926-13.328); and three factors independently associated in subtype 1b: IL28B polymorphism (OR = 3.303, CI: 2.256 -4.834), RVR (OR = 7.139, CI: 4.721-10.796), and low baseline serum HCV-RNA concentration (< 400.000 IU/ mL) (OR = 2.123, CI: 1.474-3.059). In subtype 1b the RVR status emerges as the most predictive characteristic of SVR, its strength outweighing the power of IL28 polymorphisms; on the contrary, in subtype 1a the two previous predictors appear to have an identical efficiency in predicting SVR. Conclusion: Our study conducted in a large nation-wide cohort of naïve pat

DOI : 10.1002/hep.26867

Keywords

ribavirin; interferon; RNA; clinical feature; liver disease; liver; genotype; human; patient; multivariate analysis; infection; male; Italy; therapy; serum; gender; female;