Genotype and Serum HCV RNA level are needed before Interferon
treatment
The genotype of hepatitis C virus (HCV) affects both the HCV RNA
reduction rate during intefferon-a (IFN-alpha) treatment and serum
HCV RNA levels before such treatment, a study has shown.
Earlier studies have shown that the HCV genotype and
pretreatment HCV RNA serum levels are significant for estimating
response to IFN- alpha. However, the rate of virologic response to
such therapy relative to the actual HCV genotype is not known,
noted Michinori Kohara, Tokyo Metropolitan Institute of Medical
Science, Tokyo, Japan, and colleagues ("Hepatitis C Virus Genotypes
1 and 2 Respond to lnterferon-alpha with Different Virologic
Kinetics," the Journal of Infectious Diseases, October 1995;
172(4):934-938).
Kohara et al. said that they studied the relationships between
HCV RNA levels before treatment, the HCV genotype and rates of
response to IFN-alpha therapy in patients with chronic HCV
infection.
"The results of the present study indicate that the rate of
reduction of HCV RNA during IFN-alpha treatment and serum HCV RNA
levels before IFN-alpha treatment depend on HCV genotype," wrote
Kohara et al. " HCV genotype and serum HCV RNA level (especially
for genotype 1) should be determined before IFN-alpha treatment in
order to provide the most effective treatment for HCV infected
patients."
The findings of Kohara et al. confirm previously reported
studies that have shown better response to IFN-alpha treatment in
patients with low serum HCV RNA levels before treatment or with HCV
genotype 2 (Lau, J.Y.N., et al., "Significance of Serum Hepatitis C
Virus RNA Levels in Chronic Hepatitis C," Lancet,
1993;341:1501-1504; Kanai, K., et al, "HCV Genotypes in Chronic
Hepatitis C and Response to Interferon," Lancet, 1992;339: 1543;
and Yoshioka, K., et al., "Detection of Hepatitis C Virus by
Polymerase Chain Reaction and Response to Interferon-alpha Therapy:
Relationship to Genotypes of Hepatitis C Virus," Hepatology, 1992;
16:293-299).
"In the present study, the proportion of CR-SR patients with HCV
genotype 2 was much higher than in patients with genotype 1," wrote
Kohara et al. "More importantly, the present study showed that the
higher sensitivity of patients with HCV genotype type 2 HCV is due
to a higher rate of viral RNA reduction during IFN-alpha
treatment."
Investigators have established that chronic hepatitis C
infection is associated with the development of cirrhosis and
hepatocellular carcinoma. Currently, the only therapy for chronic
HCV infection that is effective is IFN-alpha. IFN-alpha has been
helpful in approximately 30 to 40 percent of patients with chronic
HCV infection, half of whom have had relapses after the treatment
is stopped, noted Kohara et al.
Financial support was provided by grants from Tokyo Metropolitan
Government (for Specially Promoted Research on Viral Diseases) and
the ministries of Education, Science and Culture and of Health and
Welfare of Japan; American Liver Foundation (Hans Popper Liver
Scholar Award); and Glaxo Institute of Digestive Health (clinical
investigator award).
The corresponding author for this study is Dr. Michinori
Kohara, DEpartment of Microbiology, Tokyo Metropolitan Institute of
Medical Science, 3-18-22, Honkomagome, Bunkyo-ku, Tokyo 113,
Japan.
By Cathy Clark News Editor
Blood Weekly, 01-01-1995, pp 13
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