March 22, 2014

Metabolic syndrome is associated with poor treatment response to antiviral therapy in chronic hepatitis C genotype 3 patients

Eur J Gastroenterol Hepatol. 2014 Mar 17. [Epub ahead of print]

Aziz H1, Gill U, Raza A, Gill ML.


INTRODUCTION: Hepatitis C viral (HCV) infection is caused by an RNA virus. HCV infection is considered to induce systemic disease that causes steatosis, alters lipid metabolism, and results in metabolic syndrome. This study aimed to investigate the therapeutic outcome in HCV genotype 3 patients with metabolic syndrome.

MATERIALS AND METHODS: A total of 621 HCV-positive patients who visited the hospital for treatment were screened. Among these, 441 patients were enrolled for antiviral therapy. These enrolled patients were assessed for metabolic syndrome according to the International Diabetes Federation criteria. Group A included patients with metabolic syndrome and group B included patients without metabolic syndrome. All patients received peginterferon-α2a (180 μg/week) and ribavirin (10 mg/kg/day) for 6 months.

RESULTS: The prevalence of metabolic syndrome in chronic HCV patients was 37.9%. We observed that metabolic syndrome was more common among female compared with male participants (43.9 vs. 28.8%, P=0.005). It was found that sustained virologic response (SVR) rates were significantly higher in the patients in group B (without metabolic syndrome) compared with the patients in group A who had metabolic syndrome (72.2 vs. 43.7%, P<0.05). Older patients were at a higher risk for metabolic syndrome and a correlation of metabolic syndrome with nonresponse to antiviral therapy was observed. An interesting correlation among metabolic syndrome, age, and SVR was found: with age, SVR decreases, while metabolic syndrome increases.

CONCLUSION: Metabolic syndrome has an influence on therapeutic outcomes in terms of SVR. Moreover, this information can identify patients who might have a low chance of attaining an SVR and a timely decision may protect the patients from the adverse effects of therapy.

PMID: 24642690 [PubMed - as supplied by publisher]


Long-term maintenance of sustained virological response in liver transplant recipients treated for recurrent hepatitis C

Dig Liver Dis. 2014 Mar 10. pii: S1590-8658(14)00207-2. doi: 10.1016/j.dld.2014.01.157. [Epub ahead of print]

Ponziani FR1, Viganò R2, Iemmolo RM3, Donato MF4, Rendina M5, Toniutto P6, Pasulo L7, Morelli MC8, Burra P9, Miglioresi L10, Merli M11, Di Paolo D12, Fagiuoli S7, Gasbarrini A13, Pompili M13; on behalf of AISF RECOLT-C Group, Belli L, Gerunda GE, Marino M,Montalti R, Di Benedetto F, De Ruvo N, Rigamonti C, Colombo M, Rossi G, Di Leo A, Lupo L, Memeo V, Bringiotti R, Zappimbulso M,Bitetto D, Vero V, Colpani M, Fornasiere E, Pinna AD, Morelli MC, Bertuzzo V, De Martin E, Senzolo M, Ettorre GM, Visco-Comandini U,Antonucci G, Angelico M, Tisone G, Giannelli V, Giusto M.


BACKGROUND: The recurrence of hepatitis C viral infection is common after liver transplant, and achieving a sustained virological response to antiviral treatment is desirable for reducing the risk of graft loss and improving patients' survival.

AIM: To investigate the long-term maintenance of sustained virological response in liver transplant recipients with hepatitis Crecurrence.

METHODS: 436 Liver transplant recipients (74.1% genotype 1) who underwent combined antiviral therapy for hepatitis Crecurrence were retrospectively evaluated.

RESULTS: The overall sustained virological response rate was 40% (173/436 patients), and the mean follow-up after liver transplantation was 11±3.5 years (range, 5-24). Patients with a sustained virological response demonstrated a 5-year survival rate of 97% and a 10-year survival rate of 93%; all but 6 (3%) patients remained hepatitis C virus RNA-negative during follow-up. Genotype non-1 (p=0.007), treatment duration >80% of the scheduled period (p=0.027), and early virological response (p=0.002), were associated with the maintenance of sustained virological response as indicated by univariate analysis. Early virological response was the only independent predictor of sustained virological response maintenance (p=0.008).

CONCLUSIONS: Sustained virological response achieved after combined antiviral treatment is maintained in liver transplant patients with recurrent hepatitis C and is associated with an excellent 5-year survival.

Copyright © 2014 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

KEYWORDS: HCV antiviral treatment, Hepatitis C recurrence, Liver transplantation, Sustained viral response

PMID: 24635906 [PubMed - as supplied by publisher]