Influence of genotype & level of viremia on the severity of
liver injury and reponse to Inteferon
Background:
We wanted to investigate the influence of viral genotype on the
severity of liver injury and response to interferon and whether the
level of viremia differs in accordance with genotype, severity of
liver disease, and response to interferon in patients with
hepatitis C virus (HCV) infection.
Methods:
We studied 118 patients with HCV-related liver disease. HCV
genotypes were determined with a line probe assay, and serum HCV
RNA levels with a competitive reverse transcription polymerase
chain reaction assay.
Results:
HCV type Ib was the most prevalent genotype (88%). It was present
in 100% of cirrhotic patients, with or without hepatocellular
carcinoma (HCC), but only in 78% of patients with chronic hepatitis
(P <0.001). The response to interferon was better in patients
infected with non-lb HCV genotypes (P = 0.002). In a multivariate
analysis non-lb HCV genotypes and a low hepatic fibrosis correlated
with a favorable response to interferon. Among patients with
chronic hepatitis those infected with HCV type Ib were older (P
< 0.001), and age was the only independent factor associated
with HCV type Ib. Viremia levels differed neither between genotypes
nor in response to interferon and was significantly lower in
patients with cirrhosis and HCC.
Conclusions:
HCV 1b was associated with more severe liver disease and a worse
response to interferon therapy. Non-lb genotypes and a lower liver
fibrosis were the only independent predictors of a favorable
response to interferon. Levels of HCV viremia differed neither
among different genotypes nor in response to interferon and
decreased with advanced liver disease.
Author: FERNANDEZ I, HOSP 12 OCTUBRE, SERV APARATO DIGEST,
CTRA ANDAULUCIA KM 54, E-28041 MADRID, SPAIN
Source: SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY 1997
JAN;32(1):70-76
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