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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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