INFLUENCE OF HCV GENOTYPE 1 SUBTYPES ON THE VIRUS RESPONSE TO PEG INTERFERON ALPHA-2a PLUS RIBAVIRIN THERAPY

Florence Nicot (1) , Laurent Alric (2) , Karl Barange (3) , Sophie Métivier (3) , Jean-Michel Dramard (4) , Jean-Marc Combis (5) , Bernard Castan (6) , Jean-Jacques Meurisse (7) , Jean-Louis Payen (8) , Daniel Garipuy (9) , Hervé Desmorat (10) , Jean-Marie Peron (11) , Sophie Thebault (12) , Thierry Morin (13) , Christophe Renou (14) , Pierre Barel (15) , Bruno Guérin (16) , Yves Imbert (17) , Stéphane Sire (18) , Karine Sandres-Sauné (19) , Etienne Chatelut (20) , Jacques Izopet (21)

1 Virology Laboratory
2 Département d'hépatologie et de gastroentérologie
3 Gastroenterology
4 Gastroenterology
5 Gastroenterology
6 General Medicine
7 Gastroenterology
8 Internal Medicine
9 Ducuing Hospital
10 Polyclinique du Parc
11 Hepato-gastro-enterology
12 Internal Medicine
13 Gastroenterology
14 Hepatology
15 Hospital
16 Internal Medicine
17 Internal Medicine
18 Gastroenterology
19 Laboratory of Virology
20 EA3035
21 Laboratoire Virologie [CHU Toulouse]

New factors that influence the viral response in HCV non-genotype 2/3 patients must be identified in order to optimize anti-HCV treatment. This multicenter prospective study evaluates the influence of HCV variability and pharmacological parameters on the virological response of these patients to pegylated interferon α2a (peg-IFN-α2a: 180 µg/week) and ribavirin (800-1200 mg/day) for 48 weeks. HCV subtypes were identified by sequencing the NS5B region. Serum ribavirin and peg-IFN-α2a concentrations were measured at weeks 4 and 12. The 115 patients (67 men; median age=49, range [31-76]) included 64 who had never been treated and 27 co-infected with HIV. The mean baseline HCV RNA was 6.30 ± 0.06 log IU/mL and the HCV genotypes were: G1 (n=93) with 1a (n=37) and 1b (n=50), G4 (n=20) and G5 (n=2). Most patients (79/108; 73%) had an early virological response. Independent predictors of an early virological response were interferon naive patients (OR=2.98 [1.15; 7.72]) and ribavirin of > 2,200 ng/mL at week 12 (OR=3.41 [1.31; 8.90]). Forty of 104 patients (38%) had a sustained virological response. The only independent predictors of a sustained virological response were subtype 1b (OR=6.82 [1.7; 26.8]), and HCV RNA <15 IU/mL at week 12 (OR=25 [6.4; 97.6]). Thus a serum ribavirin concentration of > 2,200 ng/mL was associated with an early virological response and patients infected with HCV subtype 1b had a better chance of a sustained virological response than did those infected with subtype 1a.

Mots clés: Medicine

Florence Nicot, Laurent Alric, Karl Barange, Sophie Métivier, Jean-Michel Dramard, et al.. INFLUENCE OF HCV GENOTYPE 1 SUBTYPES ON THE VIRUS RESPONSE TO PEG INTERFERON ALPHA-2a PLUS RIBAVIRIN THERAPY. Journal of Medical Virology, 2011, 83 (3), pp.437. ⟨10.1002/jmv.21976⟩. ⟨hal-00610731⟩