Brief Reports
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2005; 11(27): 4241-4245
Published online Jul 21, 2005. doi: 10.3748/wjg.v11.i27.4241
Co-infection of SENV-D among chronic hepatitis C patients treated with combination therapy with high-dose interferon-alfa and ribavirin
Chia-Yen Dai, Wan-Long Chuang, Wen-Yu Chang, Shinn-Cherng Chen, Li-Po Lee, Ming-Yen Hsieh, Nei-Jen Hou, Zu-Yau Lin, Ming-Yuh Hsieh, Liang-Yen Wang, Ming-Lung Yu
Chia-Yen Dai, Wan-Long Chuang, Wen-Yu Chang, Shinn-Cherng Chen, Li-Po Lee, Ming-Yen Hsieh, Nei-Jen Hou, Zu-Yau Lin, Ming-Yuh Hsieh, Liang-Yen Wang, Ming-Lung Yu, Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, China
Chia-Yen Dai, Nei-Jen Hou, Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan, China
Chia-Yen Dai, Department of Occupational Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan, China Supported by the National Science Council Grant, No. NSC-91-2314-B037-344
Author contributions: All authors contributed equally to the work.
Correspondence to: Ming-Lung Yu, MD, PhD, Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, No. 100, Shih-Chuan 1st Road, Kaohsiung 807, Taiwan, China. d780178@kmu.edu.tw
Telephone: +886-7-3121101-7475 Fax: +886-7-3123955
Received: November 8, 2004
Revised: December 15, 2004
Accepted: December 20, 2004
Published online: July 21, 2005
Abstract

AIM: The clinical significance of co-infection of SENV-D among patients with chronic hepatitis C (CHC) and response of both viruses to combination therapy with high-dose interferon-alfa (IFN) plus ribavirin remain uncertain and are being investigated.

METHODS: Total 164 (97 males and 67 females, the mean age 48.1 ± 11.4 years, range: 20-73 years, 128 histologically proved) naive CHC patients were enrolled in this study. SENV-D DNA was tested by PCR method. Detection of serum HCV RNA was performed using a standardized automated qualitative RT-PCR assay (COBAS AMPLICOR HCV Test, version 2.0). HCV genotypes 1a, 1b, 2a, 2b, and 3a were determined by using genotype-specific primers. Pretreatment HCV RNA levels were determined by using the branched DNA assay (Quantiplex HCV RNA 3.0). There are 156 patients receiving combination therapy with IFN 6 MU plus ribavirin for 24 wk and the response to therapy is determined.

RESULTS: Sixty-one (37.2%) patients were positive for SENV-D DNA and had higher mean age than those who were negative (50.7 ± 10.6 years vs 46.6 ± 11.6 years, P = 0.026). The rate of sustained viral response (SVR) for HCV and SENV-D were 67.3% (105/156) and 56.3% (27/48), respectively. By univariate analysis, the higher rate of SVR was significantly related to HCV genotype non-1b (P < 0.001), younger ages (P = 0.014), lower pretreatment levels of HCV RNA (P = 0.019) and higher histological activity index (HAI) score for intralobular regeneration and focal necrosis (P = 0.037). By multivariate analyses, HCV genotype non-1b, younger age and lower pretreatment HCV RNA levels were significantly associated with HCV SVR (odds ratio (OR)/95% confidence interval (CI): 12.098/0.02-0.19, 0.936/0.890-0.998, and 3.131/1.080-9.077, respectively). The SVR of SENV-D was higher among patients clearing SENV-D than those who had viremia at the end of therapy (P = 0.04).

CONCLUSION: Coexistent SENV-D infection, apparently associated with higher ages, is found in more than one-third Taiwanese CHC patients. Both HCV and SENV-D are highly susceptible to combination therapy with high-dose IFN and ribavirin and SENV-D co-infection does not affect the HCV response. HCV genotype, pretreatment HCV RNA levels and age are predictive factors for HCV SVR.

Keywords: Chronic hepatitis C, Combination therapy, Interferon, Ribavirin, SENV-D