IP-10 predicts viral response and therapeutic outcome in difficult-to-treat patients with HCV genotype 1 infection - PubMed (original) (raw)

Randomized Controlled Trial

. 2006 Dec;44(6):1617-25.

doi: 10.1002/hep.21407.

Ana I Romero, Johan Westin, Gunnar Norkrans, Amar P Dhillon, Jean-Michel Pawlotsky, Stefan Zeuzem, Michael von Wagner, Francesco Negro, Solko W Schalm, Bart L Haagmans, Carlo Ferrari, Gabriele Missale, Avidan U Neumann, Elke Verheij-Hart, Kristoffer Hellstrand; DITTO-HCV Study Group

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Randomized Controlled Trial

IP-10 predicts viral response and therapeutic outcome in difficult-to-treat patients with HCV genotype 1 infection

Martin Lagging et al. Hepatology. 2006 Dec.

Abstract

Plasma from 173 patients with HCV genotype 1 infection was analyzed for IP-10 levels prior to treatment with pegylated interferon-alpha-2a and ribavirin. Significantly lower IP-10 levels were observed in patients achieving a rapid viral response (RVR) (P < .0001), even in those with body mass index (BMI) > or = 25 kg/m2 (P = .004) and with baseline viral load > or = 2 million IU/mL (P = .001). Similarly, significantly lower IP-10 levels were observed in patients obtaining a sustained viral response (SVR) (P = .0002), including those having higher BMI (P < .05), higher viral load (P = .0005), and both higher BMI and viral load (P < .03). In multivariate logistic regression analyses, a low IP-10 value was independently predictive of both RVR and SVR. A baseline cutoff IP-10 value of 600 pg/mL yielded a negative predictive value (NPV) of 79% (19/24) for all genotype 1-infected patients, which was comparable with that observed using a reduction in HCV-RNA by at least 2 logs after 12 weeks of therapy (NPV 86%; 19/22); by combining the two, 30 of 38 patients (NPV 79%) potentially could have been spared unnecessary therapy. In patients having both higher BMI and viral load, cut-off levels of 150 and 600 pg/mL yielded a positive predictive value (PPV) of 71% and NPV of 100%, respectively. In conclusion, pretreatment IP-10 levels predict RVR and SVR in patients infected with HCV genotype 1, even in those with higher BMI and viral load. A substantial proportion of the latter patients may achieve SVR in spite of unfavorable baseline characteristics if their pretreatment IP-10 level is low. Thus, pretreatment IP-10 analysis may prove helpful in decision-making regarding pharmaceutical intervention.

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