The rs12979860 genetic polymorphism in the interferon-λ3–interferon-λ4 (IFN元-IFNL4) region has been found to be a major determinant of hepatic inflammatory and fibrotic progression in CHC patients of mainly Caucasian origin however, it is not known if this association applies to other ethnicities, including Pakistani CHC patients. Risk and progression of liver fibrosis and cirrhosis in chronic hepatitis C (CHC) patients is significantly influenced by host genetic factors in a polygenic manner. The chemokine ratios had significant correlations with liver transaminases in treated groups whether pre or post-treatment.īaseline MIP-1β/IL-12p40 ratio represents a non-invasive prognostic biomarker that would provide shorter treatment duration and minimizes the emergence of drug-resistant variants in HCV genotype 4-patients. The calculated threshold for predicting virologic response was 8.245, with positive and negative predictive values of 92.98% and 100% respectively. Accordingly, a predictive threshold of baseline chemokine ratio was calculated and it showed an AUC of 0.6917 (P= 0.0108 95% CI: 0.5566 to 0.8268). Multivariate regression analysis of baseline characteristics showed that gender, age, viral load, albumin level and chemokine ratios can significantly predict treatment outcome (P= 0.0114, 0.0095, 0.042, 0.0004 and < 0.0001 respectively). No difference was observed in the baseline chemokines levels between responders and relapsers, but the later had a significantly higher MIP-1β/IL-12p40 ratio (P< 0.0001). Liver transaminases, total bilirubin and albumin were biochemically tested, viral RNA was quantified, and circulating MIP-1β and IL-12p40 were estimated using human anti-MIP-1β and IL-12p40 antibodies in Sandwich ELISA. Sera of 450 treatment-naïve chronic HCV patients and 50 healthy individuals were collected. This study aimed to evaluate the prognostic value of baseline macrophage inflammatory protein (MIP)-1β/IL12p40 ratio for antiviral treatment outcome in HCV genotype 4 patients. Further research on predictive factors of response is required in order to develop more reliable and reproducible predictive models. The effectiveness and safety of direct-acting antivirals against hepatitis C virus have been maintained in routine clinical practice. The multivariate analysis detected the following independent factors of non-response: body mass index ≥30 and presence of complications related to liver disease.Conclusion. Presence of diabetes and complications related to liver disease (splenomegaly, portal hypertension, portal hypertensive gastropathy), body mass index ≥30, greater liver fibrosis, receiving simeprevir and higher baseline levels of glucose, aspartate-aminotransferase, alanine-aminotransferase and alkaline-phosphatase, have been identified as predictive factors of non-response (p < 0.05). The univariate analysis identified a higher baseline of platelets, albumin and total cholesterol as predictive factors of sustained virologic response (p < 0.05). 67.9% of the patients experienced adverse drugs reactions (92.2% were grade 1). Sustained virologic response rate was 94.6%. A total of 333 treatment regimens corresponding to 330 different patients were evaluated. Univariate and multivariate analysis were done to determine factors of response.Results. Achievement of sustained virologic response was also recorded. Adverse drug reactions that occurred were recorded until week 24 of follow-up. Clinical, virological and pharmacotherapeutic variables were registered at baseline. Single-center, observational, retrospective study. Our aim was to establish the effectiveness of these drugs in routine clinical practice, as well as to determine factors that could influence the response to the treatment.Matherials/methods. Despite the high efficacy and safety of direct-acting antivirals against hepatitis C virus shown in clinical trials, treatment failures continue to occur.
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