Establishment of predictors in treatment response of chronic hepatitisC by mutational analysis of internal ribosome entry site within hepatitis C virus

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Combination therapy with pegylated interferon and ribavirin (below, PEG/RBV treatment) was performed, and 60 or more cases of Chronic Hepatitis C (below, CH-C), resulting in responders, non-responders and relapsers, were analyzed. An analysis was performed ofthe genetic mutation in the internal ribosome entry site (below, IRES) area of the HCV RNA in each case. In the non-response group, many cases had a history of previous interferon therapy, and in those cases, many cases had no mutations in the IRES domain III (below, d III) area. On the other hand, in the response cases, there was a tendency (P<0.05) for many cases to have mutation in IRES d III. In other words, this indicates that there is a possibility that resistant HCV due to previous antiviral therapy is being selected. In the relapse cases, when an analysis was performed of the IRES base mutation cloned from blood serum at the conclusion of treatment (when negative, by a commercially available HCV RNA qualitative metho), it was found that there was a characteristic mutation in base 119 in the IRES area. In the non-response group and response group for PEG/RBV treatment, when IRES base 119 mutations were compared, a discrepancy was observed between both groups, and furthermore, a correlation was found with HCV core area mutations. In other words, a correlation was indicated between the relationship between HCV IRES base mutations and core mutations, and the treatment results. In the search for thetreatment resistant mechanism as a viral factor, this is believed to be an important finding.