Differences in viral kinetics between genotypes 1 and 3 of hepatitis C virus and

December 12, 2006

World J Gastroenterol. 2006 Dec 7;12(45):7271-7.

Differences in viral kinetics between genotypes 1 and 3 of hepatitis C virus

and between cirrhotic and non-cirrhotic patients during antiviral therapy.

Medeiros-Filho JE, de Carvalho Mello IM, Pinho JR, Neumann AU, de Mello

Malta F, da Silva LC, Carrilho FJ.

Instituto de Medicina Tropical, Avenida Doutor Eneas de Carvalho Aguiar,

470, 05403-000, Sao o-SP, Brazil. jrrpinho@....

AIM: To evaluate the impact of hepatitis C virus (HCV) infection with

genotype 1 or 3 and the presence or absence of liver cirrhosis (LC) in the

early viral kinetics response to treatment. METHODS: Naive patients (n = 46)

treated with interferon-alpha (IFN-alpha) and ribavirin and followed up with

frequent early HCV-RNA determinations were analysed. Patients were infected

with genotype 1 (n = 28, 7 with LC) or 3 (n = 18, 5 with LC). RESULTS: The

first phase decline was larger in genotype 3 patients than in genotype 1

patients (1.72 vs 0.95 log IU/mL, P < 0.001). The second phase slope decline

was also larger in genotype 3 patients than in genotype 1 patients (0.87 vs

0.15 log/wk, P < 0.001). Differences were found in both cirrhotic and

non-cirrhotic patients. Genotype 1 cirrhotic patients had a slower 2nd phase

slope than non-cirrhotic patients (0.06 vs 0.18 log/wk, P < 0.02). None of

genotype 1 cirrhotic patients had a 1st phase decline larger than 1 log

(non-cirrhotic patients: 55%, P < 0.02). A similar trend toward a slower 2nd

phase slope was observed in genotype 3 cirrhotic patients but the 1st phase

slope decline was not different. Sustained viral response was higher in

genotype 3 patients than in genotype 1 patients (72% vs 14%, P < 0.001) and

in genotype 1 non-cirrhotic patients than in genotype 1 cirrhotic patients

(19% vs 0%). A second phase decline slower than 0.3 log/wk was predictive of

non-response in all groups. CONCLUSION: Genotype 3 has faster early viral

decline than genotype 1. Cirrhosis correlates with a slower 2nd phase

decline and possibly with a lower 1st phase slope decline in genotype 1

patients.

PMID: 17143940 [PubMed - in process

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December 12, 2006