Interferon Treatment For Chronic Hepatitis Research Articles

Peripheral Circulating Exosomal-miRNAs Potentially Mediate the Sensitivity to Interferon Treatment in Chronic Hepatitis B Virus Patients.

Pegylated interferon alfa-2b (Peg-IFN α-2b), a first-line treatment for hepatitis B virus (HBV) infection, can significantly achieve HBsAg clearance in clinic. However, only 30-40% of patients had achieved HBsAg clearance after Peg-IFN α-2b administration. The biological targets and the underline mechanisms that distinguish sensitive and insensitive populations to interferon therapy are still unclear. In the present study, only 33.33% of patients achieved HBsAg loss after 48 weeks of Peg-IFN α-2b therapy. Thirty-six exosomal-microRNAs (miRNAs) in the sensitive group were identified that might induce sensitivity specifically, whereas 32 exosomal-miRNAs in the insensitive group were identified that might induce insensitive specifically. Among these miRNAs, five miRNAs (miR-425-5p, miR-8485, miR-619-5p, miR-181a-5p, and miR-484) might increase the sensitivity to Peg-IFN α-2b therapy by regulating key genes GSK3B, KRAS, FLT1, or GRB2, whereas, 13 miRNAs (miR-195-5p, miR-215-5p, miR-9-5p, miR-130a-3p, miR-214-3p, miR-149-5p, miR-429, miR-200b-3p, miR-200c-3p, miR-16-2-3p, miR-141-3p, miR-200a-3p, and miR-218-5p) might decrease the sensitivity to Peg-IFN α-2b therapy by regulating key genes, FGF2, GSK3B, PDGFRA, FGFR1, KRAS, FLT1, MYC, TGFB2, EFNA1, MAPK9, or GRB2. Furthermore, seven novel miRNAs, namely Novel_352, Novel_459, Novel_527, Novel_677, Novel_717, Novel_749, and Novel_801 were found to be downregulated specifically in the sensitive group, whereas, Novel_142 and Novel_664 were found to be downregulated specifically in the insensitive group. Our data indicate that the serum exosomal-miRNAs could be involved in regulating the sensitivity of chronic HBV (CHB) patients to Peg-IFN α-2b therapy, which might suggest potential novel therapeutic biomarkers and standard options for CHB patients. Clinical Trials.gov ID: NCT04035837.

Type 1 diabetes mellitus due to pegylated interferon treatment of chronic hepatitis B: A case report

Type 1 diabetes mellitus due to pegylated interferon treatment of chronic hepatitis B: A case report

Prevalence of Thyroid Dysfunction in Chronic Hepatitis C Patients on Interferon Therapy

Objective: to record the prevalence of thyroid dysfunction in chronic HCV cases receiving interferon therapy Methodology: A total of 100 patients with a diagnosis of chronic Hepatitis C between 35-70 years of either sex with normal Thyroid function test at the time of commencement of therapy were included. This trial was conducted during the period 2021-22 at Services Hospital Lahore. Interferon alfa 3 million units were administered to patients three times per week, along with oral ribavirin 1000 mg or 1200 mg every day (depending on their weight) for 24 weeks. During therapy, these individuals had clinical evaluations every 2, 4, and 6 months. The presence and severity of adverse events were evaluated at each visit, along with standard laboratory tests. TSH levels were used to assess patients for thyroid illness every 2, 4, and 6 months. Results: Mean age was calculated as 48.57+11.35 years, 52(52%) were male and 48(48%) were females, frequency of thyroid dysfunction in Chronic HCV cases receiving interferon therapy was recorded in 19(19%) of the cases. Conclusion: The incidence of thyroid dysfunction in individuals taking interferon treatment for chronic hepatitis C infection is not very high. However, we recommend that those who are currently receiving treatment for chronic hepatitis C should be evaluated for thyroid dysfunction. Keywords: Chronic Hepatitis C infection, Interferon therapy, Thyroid Dysfunction,

Pretreatment serum levels of interferon-gamma-inducible protein-10 are associated with virologic response to telaprevir-based therapy

AimTelaprevir (TVR) remarkably improves the efficacy of interferon treatment for chronic hepatitis C. Interleukin-28B (IL28B) genotype and interferon-gamma-inducible protein-10 (IP-10) level predict virologic response to peg-interferon (Peg-IFN)/ribavirin (RBV) therapy. We aimed to investigate the usefulness of pretreatment serum IP-10 levels and IL28B genotyping in predicting sustained virologic response (SVR) to TVR-based triple therapy. MethodsIn this multi-center study, patients infected with hepatitis C virus genotype 1 with high viral load (⩾5.0logIU/mL) were treated with TVR for 12weeks and Peg-IFN/RBV for 24weeks in Japan. IL28B genotype, serum IP-10 levels, other clinical parameters, and drug dosages were assessed before treatment. ResultsWe included 121 patients who were treated with TVR for at least 8weeks and Peg-IFN/RBV for 24weeks. The median IP-10 levels were significantly lower in rapid virologic response (RVR) or SVR in the IL28B non-TT genotype group, with no significant difference in the TT genotype group. RVR rates were significantly lower in the group with higher serum IP-10 levels (>450pg/mL). In the non-TT IL28B genotype group, RVR and SVR rates were significantly lower in the group with higher IP-10 levels. SVR rates in the group with lower IP-10 levels (<450pg/mL) increased to 82% for those showing RVR, but reduced to 27% in the group with higher IP-10 levels for those not showing RVR. ConclusionsDetermination of serum IP-10 levels before treatment could be useful for predicting favorable virologic response to TVR-based triple therapy, especially in patients with IL28B non-TT genotype.

The Role of MicroRNAs in Response to Interferon Treatment of Chronic Hepatitis C patients.

IntroductionTreatment of HCV using a combination of pegylated interferon (PEG-IFN) and ribavirin fails in about 40% of the patients with HCV genotype 4 infections, and it is physically and economically demanding. Thus, it is highly important to identify factors that can help to predict the likelihood that a patient will respond to this treatment.MethodsIn this study, five miRNAs, i.e., miRNA-122, miRNA-199, miRNA-192, miRNA-30, and miRNA-128, were selected according to previous studies that demonstrated their noticeable functions in viral replication, indicating that they potentially could be used by host cells to control viral infections. The five miRNAs were measured using real-time, reverse transcription-polymerase chain reactions. The data were analyzed using the t-test and chi-squared test.ResultsWe found that the expression level of miRNA-122 was significantly increased in the responders’ group (p < 0.01) over that in the non-responders’ groups before and after treatment; both increased significantly (p < 0.01) compared with the normal control group.ConclusionmiR-122 might be a useful predictor for virological responses to treatment with PEG-interferon plus ribavirin therapy in patients with HCV.

Clinical observation of interferon-induced mental disorder in patients with chronic hepatitis

Objective To explore clinical haracteristics,diagnosis,treatment,prognosis and prevention of mental disorder induced by interferon. Methods Thirty cases of interferon treatment for chronic hepatitis were selected as research subjects.The psychotic symptoms of these patients induced by interferon were analysized by clinical statistics. Results The Self-Rating Depression Scale(SDS)and the Self-Rating Anxiety Scale (SAS)scores after treatment were(47.10±9.47)points and(43.00±10.34)points,these were higher than before treatment and the difference was statistically significant(t= 8.39,7.66,all P< 0.01).The incidence rates of the psychotic symptoms in this group of interferon-induced were 66.7%(20/30).The occurrence rates of headaches,insomnias,depressions,anxieties and personality changes were respectively 36.7%,30.0%,16.7%, 10.0%,10.0%.Before and after treatment,the difference was statistically significant(χ2= 15.43,P< 0.01). Conclusion The symptoms of mental disorder induced by interferon have high incidence rate and serious consequences,so early detection and early treatmentcan contribute a better prognosis. Key words: Interferon; Hepatitis,chronic; Mental disorder

MicroRNAs as predictor markers for response to interferon treatment of chronic hepatitis C genotype-4 in Egyptian patients.

BackgroundHepatitis C virus genotype 4 (HCV-4) infection is common in the Middle East and Africa, with an extraordinarily high prevalence in Egypt. MicroRNAs (miRNAs) play an important role in various diseases, including HCV infection. The aim of the present study was to assess serum miR-122, miR-221 and miR-21 expression profiles in HCV-4 patients prior to treatment with HCV-4 combination therapy (pegylated alpha interferon and ribavirin) and to determine whether the miRNAs were associated with the drug response.MethodsRNA was extracted from pretreatment serum samples, and miR-122, miR-221 and miR-21 levels were measured by quantitative PCR. The results were compared among patients with sustained virological responses (SVR) and non-responders (NR).ResultsThe expression levels of miR-21 and miR-122 were significantly different between the SVR and NR groups. Receiver operator characteristic (ROC) analysis revealed that the sensitivity, specificity and positive predictive values of miR-21 were 82.2%, 77.3% and 88.1%, respectively, with a cut-off value of 1.7. The sensitivity, specificity and positive predictive values of miR-122 were 68.9%, 59.1% and 77.5%, respectively, with a cut-off value of 3.5.Conclusion and SignificancemiR-21 and miR-122 might be useful predictors for SVR in HCV-4 patients prior to the administration of combination therapy. A higher predictive response power was obtained for miR-21 than for miR-122. These results should reduce ineffective treatments.

Lipoatrophy After Pegylated Interferon Treatment for Chronic Hepatitis C Virus Infection

Lipoatrophy After Pegylated Interferon Treatment for Chronic Hepatitis C Virus Infection

Clinical and pathogenetic aspects of the side effects of chronic viral hepatitis C alpha-interferon antiviral therapy

Aim. To investigate the relation of prooxidant and antioxidant systems with adverse effects of antiviral alpha interferon treatment in chronic hepatitis C. Methods. The study included 67 patients with chronic hepatitis C aged 19 to 45 years [males - 28 (41.8%), females - 39 (58.2%)] who were receiving antiviral treatment. Prooxidant (diene ketones and diene conjugates, malon dialdehyde) and antioxidant (catalase, superoxide dismutase, glutathione and glutathione-dependent enzymes) systems indicators were measured. According to the severity of side effects, patients were distributed to two groups. The first group consisted of 19 (28.4%) patients with transient passing adverse effects, usually manifesting as short-term flu-like syndrome after the medication injection, lasting no longer than 2-3 weeks of treatment. The second group consisted of 48 patients (71.6%) with prolonged side effects, registered throughout the whole treatment period. Results: Flu-like syndrome with intense myalgia and asthenic syndrome were the most frequent side effects (89.5 and 83.3% of cases, respectively). Dyspepsia, psychopathy and arthralgia were less common (79.2, 72.9 and 68.7%, respectively). Over than a half of the patients lost weight (7-9 kg compared to baseline weight), and also had alopecia and autoimmune thyroiditis. Most of the patients could not tolerate the treatment, 33 (49.2%) patients aborted the treatment. In patients with long-term side effects, low baseline levels of glutathione reductase, glutathione peroxidase, glutathione transferase were revealed (p 0.05). Patients with long-term side effects of antiviral treatment preserved high levels (p 0.05) of diene ketones and diene conjugates and statistically significant (p 0.05) suppression of antioxidant system at the 10-12 weeks of treatment. Conclusion. Examined patients with chronic hepatitis C had diverse activity of antioxidant system. Long-term side effects were seen in patients with low levels of parameters of antioxidant protection at the baseline.

IL28B CC genotype: a protective factor and predictor of the response to interferon treatment in chronic hepatitis C virus infection

In chronic hepatitis C-virus infection the possible role of gene variants encoding cytokines has become the focus of interest. The aim of the study was to investigate the effect of IL28B polymorphisms on the outcome of chronic hepatitis C-virus genotype 1 infection in the Hungarian population. In addition, the association between IL28B genotypes and the Th1/Th2 cytokine production of activated peripheral blood monocytes and lymphocytes was evaluated. Total of 748 chronic hepatitis C-virus genotype 1 positive patients (365 males and 383 females, aged between 18 and 82 years; mean age, 54±10 years) were enrolled, of which 420 patients were treated with pegylated interferon plus ribavirin for 24-72 weeks. Of the 420 patients, 195 patients (46.4%) achieved sustained virological response. The IL28B rs12979860 polymorphism was determined using Custom Taqman SNP Genotyping Assays (Applied Biosystems, Life Technologies, Foster, CA, USA). For cytokine studies, tumour necrosis factor-α, interleukin-2, interferon-γ, interleukin-2 and interleukin-4 production by LPS-stimulated monocytes and PMA-ionomycine activated lymphocytes were measured from the supernatant of the cells obtained from 40 hepatitis C-virus infected patients, using FACS-CBA Becton Dickinson test. The cytokine levels were compared in patients with different (CC, CT, TT) IL28B genotypes. The IL28B rs12979860 CC genotype occurred in lower frequency in hepatitis C-virus infected patients than in healthy controls (26.1% vs 51.4%, OR 0.333, p<0.001). Patients carried the T allele with higher frequency than controls (73.9%, vs 48.6%, OR 3.003, p<0.001). Pegylated interferon plus ribavirin treated patients with the IL28B CC genotype achieved higher sustained virological response rate than those with the CT genotype (58.6% vs 40.8%, OR 2.057, p = 0.002), and those who carried the T allele (41.8%, OR1.976, p = 0.002). LPS-induced TLR-4 activation of monocytes resulted in higher tumour necrosis factor-α production in patients with the IL28B CC genotype compared to non-CC individuals (p<0.01). Similarly, increased tumour necrosis factor-α, interleukin-2 and interferon-γ production by lymphocytes was found in the IL28B CC carriers (p<0.01) CONCLUSIONS: The IL28B CC genotype exerts protective effect against chronic hepatitis C-virus infection and may be a pretreatment predictor of sustained virological response during interferon-based antiviral therapy. The IL28B CC polymorphism is associated with increased Th1 cytokine production of activated peripheral blood monocytes and lymphocytes, which may play a role in interferon-induced rapid immune control and sustained virological response of pegylated interferon plus ribavirin treated patients.

Temperature rise after peginterferon alfa-2a injection in patients with chronic hepatitis C is associated with virological response and is modulated by IL28B genotype

Interferon treatment for chronic hepatitis C is associated with non-specific symptoms including fever. We aimed to determine the association of temperature changes with interferon antiviral activity. 60 treatment-naïve patients with chronic hepatitis C (67% genotype 1/4/6, 33% genotype 2/3) were admitted to start peginterferon alfa-2a and ribavirin in a clinical trial. Temperature was measured at baseline and 3 times daily for the first 24h and the maximal increase from baseline during that time (ΔTmax) was determined. Serum HCV-RNA, interferon-gamma-inducible protein-10 (IP-10) and expression of interferon-stimulated genes (ISGs - CD274, ISG15, RSAD2, IRF7, CXCL10) in peripheral blood mononuclear cells (PBMCs) were measured at very early time points, and response kinetics calculated. The IL28B single nucleotide polymorphism, rs12979860, was genotyped. Temperatures rose by 1.2±0.8°C, peaking after 12.5h. ΔTmax was strongly associated with 1st phase virological decline (r=0.59, p<0.0001) and was independent of gender, cirrhosis, viral genotype or baseline HCV-RNA. The association with 1st phase decline was seen in patients with rs12979860CC genotype (r = 0.65, p <0.0001) but not in CT/TT (r = 0.13, p = 0.53) and patients with CC genotype had a higher DTmax (1.4 ± 0.8 C vs. 0.8 ± 0.6 +C, p = 0.001). DTmax was associated with 6- and 24-h induction of serum IP-10 and of PBMC ISG expression, but only in patients with rs12979860CC [corrected].ΔTmax weakly predicted early virological response (AUC=0.68, CI 0.49-0.88). Temperature rise following peginterferon injection is closely associated with virological response and is modulated by IL28B polymorphism, reflecting host interferon-responsiveness.

Interferon treatment of chronic hepatitis C: Basic immunobiology and immunopathology of the liver

This article reviews the main aspects of chronic hepatitis C (epidemiological, genomic related to enhanced molecular understanding of the life cycle of the hepatitis C virus, HCV) especially standard therapy with pegilated interferon α and ribavirin. Emphasis is also placed on the immune response of the liver to HCV and the assessment of liver fibrosis via transient elastography.

Gene polymorphisms of interleukin-28, p21-activated protein kinases 4, and response to interferon-α based therapy in Chinese patients with chronic hepatitis B

Background Peg-Interferon-α treatment is expensive and associated with considerable adverse effects, selection of patients with the highest probability of response is essential for clinical practice. The objective of this study was to assess the relationship between the gene polymorphisms of interleukin-28 (IL-28), p21-activated protein kinase 4 (PAK4) and the response to interferon treatment in chronic hepatitis B patients. Methods Two hundred and forty interferon-naive treatment HBeAg seropositive chronic hepatitis B patients were enrolled in the present prospective nested case-control study. Peripheral blood samples were collected, including 92 with favorable response and 148 without response to the interferon treatment. Rs8099917, rs12980602, and rs9676717 SNP was genotyped using matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS). Results IL-28 genotype was not associated with response to interferon treatment (OR for GT/GG vs. TT, 0.881 (95% CI 0.388−2.002); P=0.762; OR for CT/CC vs. TT, 0.902 (95% CI 0.458-1.778); P=0.766). Rs9676717 in PAK4 genotype was independently associated with the response (OR for CT/CC vs. TT, 0.524 (95% CI 0.310-0.888); P=0.016). When adjusting for age, gender, smoking, drinking, levels of hepatitis B virus DNA, and alanine aminotransferase (ALT), rs9676717 genotype TT appeared to be associated with a higher probability of response for interferon treatment (OR, 0.155 (95% CI 0.034−0.700); P=0.015). Conclusion Genotype TT for rs9676717 in PAK4 gene and no drinking may be predictive of the interferon-α treatment success.

Presence of Anti-Interferon Antibodies is Not Associated with Non-Response to Pegylated Interferon Treatment in Chronic Hepatitis B

Several factors have been related to response to pegylated interferon (PEG-IFN) in chronic hepatitis B (CHB). The occurrence of anti-IFN antibodies is associated with non-response to PEG-IFN in chronic hepatitis C. This study investigated the association between anti-IFN antibodies and response to PEG-IFN in CHB. Presence of anti-IFN antibodies was assessed at baseline and at 3 and 6 months post-treatment in 323 CHB patients treated with PEG-IFN for 1 year. At baseline, anti-IFN antibodies were detected in 112 (35%) patients. Prevalence was higher in HBeAg-negative compared to HBeAg-positive CHB (43% versus 31%, respectively; P=0.03). Detection of anti-IFN antibodies was not associated with age, sex or HBV genotype. Presence of anti-IFN antibodies at baseline was associated with previous IFN therapy failure (P=0.04), which remained after adjustment for HBeAg status (OR 2.0, 95% CI 1.1, 3.7; P=0.03). Presence of anti-IFN antibodies at baseline was not associated with response, nor with HBV DNA or HBsAg decline (all P-values>0.3). Overall, 56 of 211 (27%) patients without anti-IFN at baseline developed anti-IFN antibodies after PEG-IFN treatment. Response rates did not differ between patients who developed anti-IFN antibodies and patients who did not develop anti-IFN antibodies during treatment (P=0.1). Anti-IFN antibodies may frequently be detected in CHB patients, and presence is associated with previous IFN therapy. However, presence or development of anti-IFN antibodies after PEG-IFN therapy is not associated with non-response to PEG-IFN treatment in CHB. There appears to be no future role for anti-IFN antibodies in predicting response to PEG-IFN in CHB.

Non-invasive assessment of hepatic fibrosis by tissue strain imaging in chronic hepatitis C patients

The development of fibrosis in hepatitis C patients is associated with increased rates of liver cancer. Assessing hepatic fibrosis during interferon treatment for chronic hepatitis C is thus an important factor in treatment planning. Complications such as bleeding may occur in association with liver biopsy and there are also some reports of sampling error [1,2]. In recent years, however, a number of studies looking at noninvasive means of assessing hepatic fibrosis have appeared in the literature [3-5]. The present study was conducted to determine whether it would be possible to apply an easily performed technique of myocardial examination to hepatic fibrosis. We have already documented our findings for strain rate imaging used to differentiate the normal condition, chronic hepatitis and cirrhosis of the liver identified by diagnostic imaging and haematology data [6]. In this study, patients identified by liver biopsy were investigated, and a comparative investigation with several fibrosis markers was carried out.

Extensive Psoriasis Induced by Pegylated Interferon Alfa-2a and Ribavirin in the Treatment of Chronic Hepatitis C

A 56-year-old man with chronic hepatitis C was treated with pegylated interferon alfa-2a in combination with ribavirin. However, psoriatic lesions appeared and worsened dramatically during therapy. Because of the extensive skin eruptions, he stopped therapy for chronic hepatitis C and subsequently started narrow-band ultraviolet B phototherapy and topical calcipotriol/betamethasone dipropionate ointment. After this, the psoriasis improved in a slow but comprehensive manner. Our case suggests that physicians should keep in mind the possibility of psoriasis as a side effect of interferon treatment for chronic hepatitis C.

Plasma Microrna Profile as a Predictor of Early Virological Response to Interferon Treatment in Chronic Hepatitis B Patients

Interferon (IFN) and pegylated interferon (PEG-IFN) treatment of chronic hepatitis B leads to a sustained virological response in a limited proportion of patients and has considerable side effects. To find novel markers associated with prognosis of IFN therapy, we investigated whether a pretreatment plasma microRNA profile could be used to predict early virological response to IFN. We performed microRNA microarray analysis of plasma samples from 94 patients with chronic hepatitis B who received IFN therapy. The microRNA profiles from 13 liver biopsy samples were also measured. The OneR feature ranking and incremental feature selection method were used to rank and optimize the number of features in the model. Support vector machine prediction engine and jack-knife cross-validation were used to generate and evaluate the prediction model. The optimized model consisting of 11 microRNAs yielded a 74.2% overall accuracy in the training group and was independently confirmed in the test group (71.4% accuracy). Univariate and multivariate logistic regression analyses confirmed its independent association with early virological response (OR=7.35; P=2.12×10(-5)). Combining the microRNA profile with the alanine aminotransferase level improved the overall accuracy from 73.4% to 77.3%. Co-transfection of an HBV replicative construct with microRNA mimics revealed that let-7f, miR-939 and miR-638 were functionally associated with the HBV life cycle. The 11 microRNA signatures in plasma, together with basic clinical variables, might provide an accurate method to assist in medication decisions and improve the overall sustained response to IFN treatment.

Surfactant protein-D is more useful than Krebs von den Lungen 6 as a marker for the early diagnosis of interstitial pneumonitis during pegylated interferon treatment for chronic hepatitis C.

To examine the usefulness of serum Krebs von den Lungen 6 (KL-6) and surfactant protein-D (SP-D) as markers of interstitial pneumonitis. Many antiviral therapies have become available for chronic hepatitis C, including pegylated interferon (PEGIFN) plus ribavirin. Since interstitial pneumonitis is a serious adverse drug reaction during interferon therapy, interferon treatment requires caution in respiratory disease patients. Hence, the predictors of interstitial pneumonitis have not been elucidated. Fifty-two chronic hepatitis C patients who received PEG-IFN plus ribavirin were studied; 14 patients received PEGIFN-α 2a, and 38 received PEG-IFN-α 2b. Serum KL-6 and SP-D levels were measured during treatment. Time changes in serum KL-6 and SP-D levels, as well as the presence of interstitial pneumonitis, were investigated. No cases of pneumonitis in which both markers were below the standard values were seen. Interstitial pneumonitis developed in 1 of the 5 patients in whom both markers were above standard values. Patients whose KL-6 levels alone exceeded the standard value had bacterial pneumonia and emphysema, not interstitial pneumonitis. Though no correlation between SP-D and KL-6 levels was observed, KL-6 levels tended to increase after interstitial pneumonitis was detected on imaging, but SP-D levels increased before imaging detection. It is important to monitor changes in levels of serum markers and other factors to avoid interstitial pneumonitis during PEG-IFN therapy. SP-D in particular may be important for early detection of interstitial pneumonitis.

A mutation in the interferon regulatory element of HBV may influence the response of interferon treatment in chronic hepatitis B patients

BackgroundA functional interferon regulatory element (IRE) has been found in the EnhI/X promoter region of hepatitis B virus (HBV) genome. The purpose of this study is to compare the gene order of responder and non-responder to interferon therapy in patients with chronic hepatitis B (CHB), so as to evaluate the relationship between IRE mutation and the response to interferon treatment for CHB patients.ResultsSynthetic therapeutic effect is divided into complete response (CR), partial response (PR) and non-response (NR). Among the 62 cases included in this study, 40 cases (64.5%) were in the response group (CR and PR) and 22 (35.5%) cases were in the NR group. Wild type sequence of HBV IRE TTTCACTTTC were found in 35 cases (56.5%), and five different IRE gene sequences. included TTTtACTTTC, TTTCAtTTTC, TTTtAtTTTC, TTTtACTTTt and cTTtACcTTC, were found in 22 cases (35.5%), 1 case (1.6%), 1 case (1.6%), 2 cases (3.2%) and 1 case (1.6%) respectively. There were 41.9%cases (26/62) with forth base C→T mutation, consisted of 32.5% (13/40) cases in response group and 59.1% (13/22) cases in NR group. Among the 35 cases with IRE sequences, there were 67.5% (27/40) cases in response group and 36.4% (8/22) in NR group, and the difference in IRE sequences between two groups was statistic significantly (P = 0.027). The result suggested that there is likely relationship between the forth base mutation (C→T) of IRE region and the response of HBV to Interferon therapy, and this mutation may partially decrease the inhibition effect of interferon on HBV.ConclusionThe forth base C→T mutation in IRE element of HBV may partially influence the response of Interferon treatment in CHB patients.

C型慢性肝炎のインターフェロン治療における地域連携パスシート導入がもたらしたチーム医療の展開

C型慢性肝炎のインターフェロン治療における地域連携パスシート導入がもたらしたチーム医療の展開