HCV: GENOTYPES, VIRAEMIA AND RESPONSE TO INTERFERON
Author: S. Magrin, R. Simonetti; M. Albanese, C. Fabiano, G.
Fiorentino, R. Messineo, D. Guerrera, M. Cutrera, F. Gianguzza, F.
Tine, L. Pagliaro. Div.Med.Interna, Ospedale Cervello; Clinica
Medica R; Dip. Biol.Cell. e dello Sviluppo, Universita di
Palermo;ITALY
Subtype 1b, whose prevalence shows geographical variations, has
been associated with severe liver disease (Cirrhosis, HCC). Thus we
assessed, by LiPA, HCV types in 262 patients living in Sicily. In
table I are shown the results obtained grouped for age, sex and
level of disease.
group age sex liver disease 1b 1a 2a 3 4
I 62±6 M(75) HCC 86% 6% 6% - 2%
(100) F(25) cirrhosis
II 47±8 M(62) CH (73) 82% 5% 4% 4% 5%
(100) F(38) cirrhosis (27)
III 41±10 M(42) CH (60) 58% 8% 16% 10% 8%
(62) F(20) cirrhosis (2)
Table I. In brackets number of patients
Group II (1989-91) and III (1995-96) were consecutively admitted
to our Departement for interferon treatment. Non-HCC patients were
younger than HCC patients. Group III was younger, showed milder
disease and responded better to interferon treatment (primary
response rate : 61% vs 49%) than group II. We have also assessed,
by bDNA test, pre-treatment HCV viremia that turned out to be lower
in group III than in group II (mean genome eq./ml 1.9x10Ø{6}
and 7,8 x10Ø{6} respectively in primary responders; 4,3
x10Ø{6} and 5,7 x10Ø{6} respectively in non responders).
Moreover direct sequencing of 5'NC amplified region was performed
in 152 patient (52 HCC), by dideoxy-termination chain method. Type
3 was found only among patients less than 45 years. Moreover only
both non-responders 1b patients non-HCC (12/63=19%) and 1b HCC
patients (5/34=15%), all over 45 years, showed the same
substitution of nucleotides A or C (-137 and/or -138) with T.
Finally 2 of non-responders 1b patients non-HCC over 45 years,
showed a new double compensatory substitution on the stem of the
5'NC secondary structure. In conclusion our results show that HCV
types prevalence depends on age and severity of liver disease in
the same geographical area, and that the above factors (comprised a
negative probable relationship of some subtypes) can influence
response to interferon treatment. Moreover the type 3 prevalence is
probably increasing, may be at expense of type 1b or closely
related subtypes. This should be always take into account in
evaluating HCV type as a risk factor for HCC or as a predictor
response to interferon.
Source: American Association for the Study of Liver Diseases
- 1996 Annual Meeting
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