Clinical trial: low plasma cholesterol and oxidative stress predict rapid virological response to standard therapy with peginterferon and ribavirin in HCV patients
Article first published online: 2 JUN 2009
© 2009 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 30, Issue 5, pages 444–451, September 2009
How to Cite
ANGELICO, F., FRANCIOSO, S., DEL BEN, M., FEOLE, K., CARBONE, M., PIGNATELLI, P., VIOLI, F. and ANGELICO, M. (2009), Clinical trial: low plasma cholesterol and oxidative stress predict rapid virological response to standard therapy with peginterferon and ribavirin in HCV patients. Alimentary Pharmacology & Therapeutics, 30: 444–451. doi: 10.1111/j.1365-2036.2009.04055.x
- Issue published online: 3 AUG 2009
- Article first published online: 2 JUN 2009
- Publication data Submitted 27 February 2009 First decision 22 March 2009 Resubmitted 19 May 2009 Accepted 28 May 2009 Epub Accepted Article 2 June 2009
Background Rapid virological response (RVR) is the best predictor of sustained response to standard HCV treatment.
Aim To evaluate predictive factors of RVR.
Methods Sixty-five patients (mean age 52.6 ± 13.8; 37 genotype-1, and 28 genotypes-2/3) were consecutively treated with pegIFN-alpha2a or 2b once weekly plus daily ribavirin based on body weight for 24 or 48 weeks, according to genotype. RVR was defined as undetectable HCV-RNA at week 4.
Results Twenty-seven percent of patients achieved RVR in genotypes 1 and 60.7% in genotypes 2/3 (P < 0.01). Rapid responders had higher mean serum baseline total and LDL-cholesterol levels (P < 0.01). RVR was 20.0% in the bottom tertile of total cholesterol and 63.6% in the top tertile (P < 0.01). HCV-RNA levels at week 4 were positively correlated with baseline serum insulin (P < 0.01), HOMA-IR (P < 0.01), body mass index (P < 0.05) and number of components of metabolic syndrome (P < 0.01) and negatively correlated with cholesterol levels (P < 0.05). At multivariate analysis, age, LDL-cholesterol, HCV genotype and serum 8-iso-PGF2alpha, a marker of oxidative stress, were independent predictors of RVR.
Conclusions Our prospective study supports a role of low serum total and LDL-cholesterol and of oxidative stress as positive independent predictive factors of poor RVR in HCV patients.