Predictive values of amino acid sequences of the core and NS5A regions in antiviral therapy for hepatitis C: a Japanese multi-center study
Predictive values of amino acid sequences of the core and NS5A regions in antiviral therapy for hepatitis C: a Japanese multi-center study
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DOI：
10.1007/s00535-009-0087-x
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发表时间：
2009-06
影响因子：
6.3
通讯作者：
T. Okanoue;Y. Itoh;Hiroaki Hashimoto;K. Yasui;M. Minami;T. Takehara;E. Tanaka;M. Onji;J. Toyota;K. Chayama;K. Yoshioka;N. Izumi;N. Akuta;H. Kumada
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文献类型：
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作者：
T. Okanoue;Y. Itoh;Hiroaki Hashimoto;K. Yasui;M. Minami;T. Takehara;E. Tanaka;M. Onji;J. Toyota;K. Chayama;K. Yoshioka;N. Izumi;N. Akuta;H. Kumada
背景慢性丙型肝炎（CHC）基因1b型高病毒载量患者对聚乙二醇干扰素（PEG-IFN）和利巴韦林（RBV）联合治疗耐药，尤其是老年和女性患者。方法为了阐明影响早期和持续病毒应答（EVR和SVR）的因素，409例基因1b型高病毒载量CHC患者接受了48周的PEG-IFN/RBV治疗。分析HCV核心70和91位的氨基酸（aa）序列以及干扰素敏感性决定区（ISDR）的氨基酸序列。宿主因素，病毒因素，治疗相关因素进行多变量analysis.ResultsMale性别，低HCV RNA载量，高血小板计数，两个或两个以上的氨基酸突变的ISDR，和野生型的核心氨基酸70是独立的预测因素SVR。在80%以上的粘附PEG-IFN和RBV，男性性别，轻度纤维化阶段，和野生型的核心氨基酸70 SVR的独立预测因子。结论SVR的独立预测因素是：没有氨基酸取代在核心氨基酸70，两个或两个以上的氨基酸突变的ISDR，低病毒载量，高值的血小板计数，轻度肝纤维化和男性。
BackgroundChronic hepatitis C (CHC) genotype 1b patients with high viral load are resistant to peginterferon (PEG-IFN) and ribavirin (RBV) combination therapy, especially older and female patients.MethodsTo elucidate the factors affecting early and sustained viral responses (EVR and SVR), 409 genotype 1b patients CHC with high viral loads who had received 48 weeks of PEG-IFN/RBV therapy were enrolled. The amino acid (aa) sequences of the HCV core at positions 70 and 91 and of the interferon sensitivity determining region (ISDR) were analyzed. Host factors, viral factors, and treatment-related factors were subjected to multivariate analysis.ResultsMale gender, low HCV RNA load, high platelet count, two or more aa mutations of ISDR, and wild type of core aa 70 were independent predictive factors for SVR. In patients with over 80% adherences to both PEG-IFN and RBV, male gender, mild fibrosis stage, and wild type of core aa 70 were independent predictors for SVR.ConclusionsIndependent predictive factors for SVR were: no aa substitution at core aa 70, two or more aa mutations in the ISDR, low viral load, high values of platelet count, mild liver fibrosis and male gender.