Аналіз ефективності фармакотерапії хворих на хронічний гепатит С пегільованим інтерфероном і рибавірином залежно від виду інтерферону та генотипу хворих за генами GSTs

Abstract

Two licensed products of peginterferon alfa (peginterferon alfa-2a and peginterferon alfa-2b) are available for the treatment of chronic hepatitis C (CHC). The efficacy of this treatment depends on the virus genotype, baseline viral load, and several host factors, e.g. age, ethnicity, and genetic polymorphisms. To investigate efficacy of peginterferon alfa-2a and peginterferon alfa-2b in treatment of CHC patients and the influence of polymorphisms of genes GSTT1, GSTM1 and GSTP1 on this treatment. We studied efficacy of treatment in 29 patients with CHC. The patients were divided into 2 groups: I group — 21 patients who were treated by the peginterferon alfa-2a plus ribavirin; II group — 8 patients — peginterferon alfa-2b plus ribavirin. Rapid virological response (RVR), early virological response (EVR), non-response rate, and ALT level were compared between 2 groups. Deletion polymorphisms of genes GSTM1, GSTT1 and A313G polymorphism of GSTP1 were studied by PCR. RVR + EVR were lower in patients of II group than in patients of I group (25.00 vs. 66.68%, р=0.044). We defined significant association of AA genotype of the gene GSTP1 with slow virological response (60.00 vs. 17.65%, р=0.024) and higher levels of serum ALT after 12 weeks of treatment ((1.06±0.77) vs. (0.60±0.31) mmol/l, р=0.03). The efficacy of treatment by peginterferon alfa-2a was better than by peginterferon alfa-2b. Patients with AA genotype of the gene GSTP1 demonstrated higher virological levels and higher levels of serum ALT after 12 weeks of treatment than patients with AG + GG genotypes.

Изучили эффективность лечения больных хроническим гепатитом С (ХГС) по схеме пегилированный (ПЕГ) интерферон + рибавирин в зависимости от вида интерферона (ПЕГ-интерферон альфа-2а или ПЕГ-интерферон альфа-2b) и генотипа больных по генам GSTT1, GSTM1 и GSTP1. Установили, что эффективность лечения ХГС выше в группе больных, которые получали терапию ПЕГ-интерферон альфа 2а + рибавирин. На эффективность лечения влияет А313G полиморфизм гена GSTP1. Худшие результаты наблюдаются у больных с генотипом АА, чем с генотипами AG + GG.