Antiviral Treatment of Chronic Hepatitisс: Available Results and Future Prospects

Abstract

Objective : to evaluate the effectiveness of two interferon (IFN)-based antiviral therapy of chronic hepatitis C (IFN/RBV or PEG-IFN/RBV)depending on HCV genotype, IL-28B gene mutations and to determinethe group of patients who need treatment with direct antiviral agents. Material and methods. The study involved 844 patients with chronic hepatitis C (60.6 % men; 51.9 % with genotype 1 virus) in two infectious diseases hospitals. 324 patients received treatment with standard interferon and ribavirin (IFN/RBV), 520 patients - with pegylated interferon and ribavirin (PEG-IFN/RBV). Polymerase chain reaction was applied to determinesingle nucleotide polymorphisms (SNPs) rs12979860 and rs8099917 of IL-28B gene. Results. The effectiveness (sustained virologic response, SVR) of the scheme IFN/RBV in patients with HCV genotype 1 was 23.9 %, and of PEG-IFN/RBV - 48.4 %. The highest frequency rate of SVR was recorded in patients with CC variant of SNP rs12979860 - 73.3 and 82.1 % (for IFN/RBV and PEG-IFN/RBV schemes, respectively). Schemes IFN/RBV (SVR 70.8 %) and PEG-IFN/RBV (SVR 86.5 %) were highly effective for patients with HCV genotypes 2 and 3. The treatment was not effective in patients with genotype 1 HCV having gene IL-28B SNPs rs12979860 CT or TT and rs8099917 TG or GG and in patientsover 40. Conclusion. It is prospectiveto use non-IFN regimens based on direct-acting antiviral agents to treat patients with 1 HCV genotype with genotype CT/TT (rs12979860) and TG/GG (rs8099917), as well as those who did not respond previously to the antiviral treatment with PEG-IFN/RBV.The implementation of the non-IFN regimens should be accelerated by means of registration or development of production of generic drugs.