Viral Hepatitis
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Dec 7, 2006; 12(45): 7271-7277
Published online Dec 7, 2006. doi: 10.3748/wjg.v12.i45.7271
Differences in viral kinetics between genotypes 1 and 3 of hepatitis C virus and between cirrhotic and non-cirrhotic patients during antiviral therapy
José Eymard Medeiros-Filho, Isabel Maria Vicente Guedes de Carvalho Mello, João Renato Rebello Pinho, Avidan U Neumann, Fernanda de Mello Malta, Luiz Caetano da Silva, Flair José Carrilho
José Eymard Medeiros-Filho, João Renato Rebello Pinho, Luiz Caetano da Silva, Flair José Carrilho, Hepatology Branch, Department of Gastroenterology, University of São Paulo School of Medicine, São Paulo, Brazil
Isabel Maria Vicente Guedes de Carvalho Mello, Viral Immunology Laboratory, Instituto Butantan, São Paulo, Brazil
Avidan U Neumann, Faculty of Life Sciences, Bar-Ilan Univer-sity, Ramat-Gan, Israel
Fernanda de Mello Malta, Virology Branch, Instituto Adolfo Lutz, São Paulo, Brazil
Supported by the Alves de Queiroz Family Fund for Research
Correspondence to: João Renato Rebello Pinho, MD, PhD, Instituto de Medicina Tropical, Avenida Doutor Enéas de Carvalho Aguiar, 470, 05403-000, São Paulo-SP, Brazil. jrrpinho@usp.br
Telephone: +55-11-30696447 Fax: +55-11-30697830
Received: June 21, 2006
Revised: June 28, 2006
Accepted: November 6, 2006
Published online: December 7, 2006
Abstract

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-α (IFN-α) 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.

Keywords: Hepatitis C virus; Treatment; Early kinetics; Cirrhosis; Genotypes