Influence of the HCV subtype on the virological response to pegylated interferon and ribavirin therapy.

Florence Legrand-Abravanel (1, 2) , Philippe Colson (3) , Helene Le Guillou-Guillemette (4) , Laurent Alric (5) , Isabelle Ravaux (6) , Françoise Lunel-Fabiani (4) , Magali Bouvier-Alias (7) , Pascale Trimoulet (8) , Marie-Laure Chaix (9) , Christophe Hezode (10) , Juliette Foucher (11) , Hélène Fontaine (12) , Anne-Marie Roque-Afonso (13) , Michele Gassin (14) , Evelyne Schvoerer (15) , Catherine Gaudy (16) , Bruno Roche (17) , Michel Doffoel (18) , Louis Dalteroche (19) , Sophie Vallet (20) , Yazid Baazia (21) , Bruno Pozzetto (22) , Vincent Thibault (23) , Jean-Baptiste Nousbaum (24) , Dominique Roulot (25) , Henry Coppere (26) , Thierry Poynard (23) , Christopher Payan (20) , Jacques Izopet (2)

1 CPTP - Centre de Physiopathologie Toulouse Purpan
2 Laboratoire Virologie [CHU Toulouse]
3 Laboratoire de virologie
4 Laboratoire de virologie
5 Service Médecine Interne et immunologie clinique [CHU Toulouse]
6 Service des maladies infectieuses
7 Service de bactériologie, virologie, hygiène [Mondor]
8 Service de virologie et d'immunologie biologique
9 Laboratoire de Virologie [CHU Necker]
10 Service d'hépato-gastro-entérologie [APHP Henri Mondor]
11 Service d'Hépato-Gastro-Entérologie
12 Service d'hépatologie médicale [CHU Cochin]
13 Laboratoire de virologie
14 Laboratoire de virologie
15 Laboratoire de Virologie
16 Service de Bactériologie-Virologie-Hygiène [Tours]
17 CHB - Centre hépato-biliaire
18 Service d'hépato-gastroentérologie
19 Service de gastro-entérologie
20 Laboratoire de Parasitologie et Mycologiede [CHRU Brest]
21 Service de bactériologie-Virologie-Hygiène [Avicenne]
22 Laboratoire de virologie
23 CHU Pitié-Salpêtrière [AP-HP]
24 Service de gastroenterologie
25 Service de gastroenterologie
26 Service de gastroenterologie

The hepatitis C virus genotype is considered to be the most important baseline predictor of a sustained virological response in patients with chronic hepatitis C treated with pegylated interferon and ribavirin. The influence of the subtype on the sustained virological response was investigated in patients infected with genotypes 1, 4, 5 or 6. This study was done on 597 patients with chronic hepatitis C who were given pegylated interferon and ribavirin for 48 weeks. The overall rate of sustained virological response in the 597 patients was 37.8%. Univariate analysis indicated that the sustained virological response of patients infected with subtype 1b (39%) tended to be higher than that of patients infected with subtype 1a (30.6%; p=0.06) and it was similar to those patients infected with subtypes 4a (51.3%, p=0.12) or 4d (51.7%, p=0.16). Multivariate analysis indicated that five factors were independently associated with sustained virological response: the age (OR 0.97; 95% CI = 0.95-0.99), absence of cirrhosis (OR: 2.92; 95% CI = 1.7-5.0; p<0.01), absence of HIV conifection (OR: 2.08; 95% CI = 1.2-3.5; p<0.01), low baseline plasma HCV RNA concentration (OR: 1.74; 95% CI = 1.2-2.6; p<0.01) and the subtype 1b (OR: 1.61; 95% CI = 1.0-2.5; p=0.04) or subtypes 4a and 4d (OR: 2.03; 95% CI = 1.1-3.8; p=0.03). In conclusion, among difficult-to-treat genotypes, the subtype 1a is associated with a lower response to anti-HCV therapy than subtypes 1b, 4a and 4d.

Florence Legrand-Abravanel, Philippe Colson, Helene Le Guillou-Guillemette, Laurent Alric, Isabelle Ravaux, et al.. Influence of the HCV subtype on the virological response to pegylated interferon and ribavirin therapy.. Journal of Medical Virology, 2009, 81 (12), pp.2029. ⟨10.1002/jmv.21583⟩. ⟨hal-00531821⟩