Response to interferon in chronic hepatitis C due to mixed genotype infection

Abstract

We examined the response to interferon (IFN) in patients with chronic hepatitis C (CHC) due to two different genotypes of hepatitis C virus (HCV) infection. Among 64 CHC patients studied, one (2%) had HCV-RNA genotype I, 36 (56%) had genotype II, 19 (30%) had genotype III, 2 (3%) had genotype IV and 6 (9%) had both genotypes II and III. There was no significant difference in age, sex, history of blood transfusion and liver histology among patients with genotypes II, III and II + III. The HCV-RNA titre of genotype II patients was significantly higher than that of genotype III patients (P < 0.05). However, there was no significant difference in the HCV-RNA titre between genotype II + III and the other groups. The complete response rate achieved with IFN therapy was significantly higher in genotype III patients (74%) than in genotype II patients (17%; P < 0.01). Of the six patients with genotype II + III, a complete response to IFN was only achieved by two patients (33%), both of whom had a low HCV-RNA titre ( < or = 10(4.5) copies/mL) and HCV serotype 2. The remaining four patients had HCV serotype 1 and three of the patients had a high HCV-RNA titre ( > or = 10(5) copies/mL). The HCV genotype III was lost in two patients after IFN therapy. These data suggest that HCV-RNA titre and HCV serotype are important factors for predicting the efficacy of IFN therapy in patients with mixed genotype infection and show direct evidence of higher susceptibility towards CHC of patients with genotype III than genotype II.

Renal Transplant Recipient with Chronic Hepatitis C Who Obtained Sustained Viral Response after Interferon-.BETA. Therapy

“…The HCV-RNA clearance ranged from 0 to 50% and, in more than 50% of cases, the sustained virological response rate was 0%. This is in contrast with the HCV-RNA clearance rate of 30-40% in patients that did not undergo renal transplantation (4,5). This difference in response may be secondary to discontinuation of the medication secondary to rejection or due to interference of HCV clearance by the immunosuppressive state.…”

“…While interferon (IFN) therapy has been widely used for the treatment of chronic hepatitis C (4,5), previous studies do not support the use of IFN therapy for the treatment of HCV in renal transplant recipients secondary to the risk of renal rejection and the absence of evidence for a sustained viral response (6)(7)(8)(9)(10)(11)(12)(13). However, some case reports have demonstrated eradication of HCV through the use of IFN therapy in renal transplant recipients.…”

Evaluation of three different hepatitis C virus typing methods for detection of mixed‐genotype infections

“…‡ Restriction fragment length polymorphism (RFLP) for HCV genotyping was carried out as described previously by Furione et al 10 § HCV serotyping was done using Murex HCV Serotyping 1-6 Assay according to the protocol given in the kit manual. genotypes in which confounding host factors could be completely eliminated; 12 and (iii) use as a marker for monitoring the presence of risk factors in a population. 13 Though most current genotyping methods are reliable 7 for the general genotyping of HCV, none of these methods is suitable for detecting mixed genotypes.…”

Effect of mutation in the hepatitis C virus nonstructural 5B region on HCV replication

“…21 In addition, genotype 1b has less susceptibility to IFN therapy than genotype 2a. 22 Thus, HCV-RNA replication and the response to IFN therapy are different between HCV genotypes 1b and 2a. Clinically, this difference is very important for IFN therapy.…”