Abstract
Background & Aims The lack of consensus on the optimal timing, regimen, and duration of treatment, in patients with acute HCV infection, stimulates the research on both favourable outcome predictors and individualized treatment regimens. This study aimed at investigating the impact of IL28B SNP rs12979860 alone or in combination with HLA class II alleles in both predicting spontaneous viral clearance and individualizing treatment strategies for patients with HCV persistence, after acute HCV exposure. Methods 178 patients with AHC, consecutively treated with interferon alone or in combination with ribavirin, starting within or after 48 weeks from the diagnosis of AHC, were tested for IL28B SNPs and HLA class II alleles. Results Spontaneous viral clearance was achieved in 28% of 169 patients available for genetic testing. Factors associated with HCV elimination were jaundice (OR 2.75, 95% CI 1.31-5.77) and IL28B CC (OR 3.87, CI 1.71-8.51), but not HLA alleles. In CT/TT patients without jaundice, NPV for virus persistence was 98%. In patients with IL28B CT/TT, starting treatment 48 weeks after the onset was significantly associated with lower rates of response (28% vs. 100%, p = 0.027). By contrast, no significant differences in the rate of SVR were observed for CC carriers who started treatment later (65% vs. 85%, p = 1.0). Conclusions In patients with acute HCV hepatitis, lack of viral clearance may be predicted by absence of jaundice and IL28B CT/TT genotype; in patients with these characteristics, treatment needs to be started immediately.
| Original language | English |
|---|---|
| Pages (from-to) | 221-228 |
| Number of pages | 8 |
| Journal | Journal of Hepatology |
| Volume | 59 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - Aug 2013 |
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Keywords
- Acute hepatitis
- HCV hepatitis
- IL28B
- Jaundice
ASJC Scopus subject areas
- Hepatology
Cite this
Treatment optimization and prediction of HCV clearance in patients with acute HCV infection. / Mangia, Alessandra; Santoro, Rosanna; Copetti, Massimiliano; Massari, Marco; Piazzolla, Valeria; Spada, Enea; Cappucci, Giuseppe; Missale, Gabriele; Mottola, Leonardo; Agostinacchio, Ernesto; Mauro, Lazzaro Di; Zuccaro, Ornella; Maio, Patrizia; Pellegrini, Fabio; Folgori, Antonella; Ferrari, Carlo.
In: Journal of Hepatology, Vol. 59, No. 2, 08.2013, p. 221-228.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treatment optimization and prediction of HCV clearance in patients with acute HCV infection
AU - Mangia, Alessandra
AU - Santoro, Rosanna
AU - Copetti, Massimiliano
AU - Massari, Marco
AU - Piazzolla, Valeria
AU - Spada, Enea
AU - Cappucci, Giuseppe
AU - Missale, Gabriele
AU - Mottola, Leonardo
AU - Agostinacchio, Ernesto
AU - Mauro, Lazzaro Di
AU - Zuccaro, Ornella
AU - Maio, Patrizia
AU - Pellegrini, Fabio
AU - Folgori, Antonella
AU - Ferrari, Carlo
PY - 2013/8
Y1 - 2013/8
N2 - Background & Aims The lack of consensus on the optimal timing, regimen, and duration of treatment, in patients with acute HCV infection, stimulates the research on both favourable outcome predictors and individualized treatment regimens. This study aimed at investigating the impact of IL28B SNP rs12979860 alone or in combination with HLA class II alleles in both predicting spontaneous viral clearance and individualizing treatment strategies for patients with HCV persistence, after acute HCV exposure. Methods 178 patients with AHC, consecutively treated with interferon alone or in combination with ribavirin, starting within or after 48 weeks from the diagnosis of AHC, were tested for IL28B SNPs and HLA class II alleles. Results Spontaneous viral clearance was achieved in 28% of 169 patients available for genetic testing. Factors associated with HCV elimination were jaundice (OR 2.75, 95% CI 1.31-5.77) and IL28B CC (OR 3.87, CI 1.71-8.51), but not HLA alleles. In CT/TT patients without jaundice, NPV for virus persistence was 98%. In patients with IL28B CT/TT, starting treatment 48 weeks after the onset was significantly associated with lower rates of response (28% vs. 100%, p = 0.027). By contrast, no significant differences in the rate of SVR were observed for CC carriers who started treatment later (65% vs. 85%, p = 1.0). Conclusions In patients with acute HCV hepatitis, lack of viral clearance may be predicted by absence of jaundice and IL28B CT/TT genotype; in patients with these characteristics, treatment needs to be started immediately.
AB - Background & Aims The lack of consensus on the optimal timing, regimen, and duration of treatment, in patients with acute HCV infection, stimulates the research on both favourable outcome predictors and individualized treatment regimens. This study aimed at investigating the impact of IL28B SNP rs12979860 alone or in combination with HLA class II alleles in both predicting spontaneous viral clearance and individualizing treatment strategies for patients with HCV persistence, after acute HCV exposure. Methods 178 patients with AHC, consecutively treated with interferon alone or in combination with ribavirin, starting within or after 48 weeks from the diagnosis of AHC, were tested for IL28B SNPs and HLA class II alleles. Results Spontaneous viral clearance was achieved in 28% of 169 patients available for genetic testing. Factors associated with HCV elimination were jaundice (OR 2.75, 95% CI 1.31-5.77) and IL28B CC (OR 3.87, CI 1.71-8.51), but not HLA alleles. In CT/TT patients without jaundice, NPV for virus persistence was 98%. In patients with IL28B CT/TT, starting treatment 48 weeks after the onset was significantly associated with lower rates of response (28% vs. 100%, p = 0.027). By contrast, no significant differences in the rate of SVR were observed for CC carriers who started treatment later (65% vs. 85%, p = 1.0). Conclusions In patients with acute HCV hepatitis, lack of viral clearance may be predicted by absence of jaundice and IL28B CT/TT genotype; in patients with these characteristics, treatment needs to be started immediately.
KW - Acute hepatitis
KW - HCV hepatitis
KW - IL28B
KW - Jaundice
UR - http://www.scopus.com/inward/record.url?scp=84880283347&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84880283347&partnerID=8YFLogxK
U2 - 10.1016/j.jhep.2013.04.007
DO - 10.1016/j.jhep.2013.04.007
M3 - Article
C2 - 23587473
AN - SCOPUS:84880283347
VL - 59
SP - 221
EP - 228
JO - Journal of Hepatology
JF - Journal of Hepatology
SN - 0168-8278
IS - 2
ER -