Journal ArticleDOI
Valuable antiviral therapeutic options for the treatment of chronic hepatitis C patients with thrombocytopenia.
Eiichi Ogawa,Norihiro Furusyo,Masayuki Murata,Hiroaki Ikezaki,Takeshi Ihara,Takeo Hayashi,Kazuhiro Toyoda,Kyoko Okada,Mosaburo Kainuma,Eiji Kajiwara,K. Takahashi,Takeaki Satoh,Jun Hayashi +12 more
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TLDR
HOMA‐IR is a useful predictor of SVR for patients with thrombocytopenia infected with HCV genotype 1 or 2 treated with PEG‐IFNα2b and RBV, and the inclusion of IL28B, ITPA genotypes and HOMa‐IR adds valuable therapeutic information.Abstract:
Summary
Thrombocytopenia in patients with chronic hepatitis C may represent an obstacle for the initiation of antiviral treatment. The aim of this study was to evaluate factors predictive of successful pegylated interferon (PEG-IFN) α2b and ribavirin (RBV) treatment for patients with thrombocytopenia with no history of splenectomy or partial splenic embolization. One hundred and fifty-one chronic hepatitis C patients (genotype 1: n = 110, genotype 2: n = 41) with TCP (<100 × 109/L) at baseline were enrolled. Pretreatment variables included interleukin 28B (IL28B) genotype (rs8099917) and homoeostasis model assessment of insulin resistance score (HOMA-IR). The kinetics of haemoglobin and platelets according to the inosine triphosphatase (ITPA) genotype (rs1127354) were investigated. Sustained virological response (SVR) was significantly more frequent in hepatitis C virus (HCV) genotype 2 (65.9%) than in genotype 1 (34.5%) patients (P < 0.0001). Multiple logistic regression analysis of HCV genotype 1 extracted IL28B TT genotype [odds ratio (OR) 5.97, P = 0.006] and HOMA-IR <2.5 (OR 7.14, P = 0.0016) as significant independent pretreatment predictors of SVR. The analyses of HCV genotype 2 showed that HOMA-IR was significantly related to SVR, but IL28B genotype was not. Patients with ITPA CC genotype showed a significant haemoglobin reduction and lower degree of platelets decrease than those with ITPA CA/AA genotypes. The most common reason for premature discontinuation of treatment was the development of hepatocellular carcinoma (n = 8, 5.3%). In conclusion, HOMA-IR is a useful predictor of SVR for patients with thrombocytopenia infected with HCV genotype 1 or 2 treated with PEG-IFNα2b and RBV. The inclusion of IL28B, ITPA genotypes and HOMA-IR adds valuable therapeutic information.read more
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Therapeutic drug monitoring of telaprevir in chronic hepatitis C patients receiving telaprevir-based triple therapy is useful for predicting virological response
Norihiro Furusyo,Eiichi Ogawa,Masayuki Murata,Kazuhiro Toyoda,Hachiro Ohnishi,Kunimitsu Eiraku,Motohiro Shimizu,Yuji Harada,Fujiko Mitsumoto,Koji Takayama,Mosaburo Kainuma,Kyoko Okada,Jun Hayashi +12 more
TL;DR: Therapeutic drug monitoring of telaprevir in the early stage of treatment is useful in clinical practice for predicting the virological response of patients receiving telaprivir-based triple therapy.
Journal ArticleDOI
Influence of low-density lipoprotein cholesterol on virological response to telaprevir-based triple therapy for chronic HCV genotype 1b infection
Eiichi Ogawa,Norihiro Furusyo,Eiji Kajiwara,Hideyuki Nomura,Kazufumi Dohmen,Kazuhiro Takahashi,Makoto Nakamuta,Takeaki Satoh,Koichi Azuma,Akira Kawano,Yuichi Tanabe,Kazuhiro Kotoh,Shinji Shimoda,Jun Hayashi +13 more
TL;DR: The baseline LDL-C level exerted a potent influence on the SVR of treatment-experienced patients treated with TVR-based triple therapy, especially for prior partial and null responders to PEG-IFNα and RBV.
Journal ArticleDOI
Clinical Implication of Insulin Resistance in Chronic Hepatitis C Patients
TL;DR: In the near future, almost all patients with chronic HCV infection will achieve virological clearance with combined direct antiviral agents, however, insulin resistance will remain a risk for hepatocellular carcinoma, therefore, the prevention of obesity and avoidance of excessive alcohol intake are very important after achieving SVR.
References
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Journal ArticleDOI
Homeostasis model assessment : insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man
TL;DR: The correlation of the model's estimates with patient data accords with the hypothesis that basal glucose and insulin interactions are largely determined by a simple feed back loop.
Journal ArticleDOI
Clinical Management of Hepatocellular Carcinoma. Conclusions of the Barcelona-2000 EASL Conference
Jordi Bruix,Morris Sherman,Josep M. Llovet,Michel Beaugrand,Riccardo Lencioni,Andrew K. Burroughs,Erik Christensen,Luigi Pagliaro,Massimo Colombo,Juan Rodés +9 more
Journal ArticleDOI
Genetic variation in IL28B predicts hepatitis C treatment-induced viral clearance.
Dongliang Ge,Jacques Fellay,Alexander J. Thompson,Jason Simon,Kevin V. Shianna,Thomas J. Urban,Erin L. Heinzen,Ping Qiu,Arthur H. Bertelsen,Andrew J. Muir,Mark S. Sulkowski,John G. McHutchison,David Goldstein +12 more
TL;DR: It is reported that a genetic polymorphism near the IL28B gene, encoding interferon-λ-3 (IFN-α-2a) is associated with an approximately twofold change in response to treatment, both among patients of European ancestry and African-Americans.
Journal ArticleDOI
Global epidemiology of hepatitis C virus infection
TL;DR: Because there is no vaccine and no post-exposure prophylaxis for HCV, the focus of primary prevention efforts should be safer blood supply in the developing world, safe injection practices in health care and other settings, and decreasing the number of people who initiate injection drug use.
Journal ArticleDOI
Genome-wide association of IL28B with response to pegylated interferon-alpha and ribavirin therapy for chronic hepatitis C.
Yasuhito Tanaka,Nao Nishida,Masaya Sugiyama,Masayuki Kurosaki,Kentaro Matsuura,Naoya Sakamoto,Mina Nakagawa,Masaaki Korenaga,Keisuke Hino,Shuhei Hige,Yoshito Ito,Eiji Mita,Eiji Tanaka,Satoshi Mochida,Yoshikazu Murawaki,Masao Honda,Akito Sakai,Yoichi Hiasa,Shuhei Nishiguchi,Asako Koike,Isao Sakaida,Masatoshi Imamura,Kiyoaki Ito,Koji Yano,Naohiko Masaki,Fuminaka Sugauchi,Namiki Izumi,Katsushi Tokunaga,Masashi Mizokami +28 more
TL;DR: A genome-wide association study to null virological response (NVR) in the treatment of patients with hepatitis C virus (HCV) genotype 1 within a Japanese population is reported.